The Role of Furosemide Stress Test in the Intensive Care Clinic
ConditionAkut Kidney Injury
Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age18+
SponsorGulhane Training and Research Hospital
About this trial
AKI causes high mortality and morbidity, especially in critically ill patients, and prolongs the patient's stay in the intensive care unit. Due to the high morbidity and mortality associated with AKI, many researchers are studying several new biomarkers for earlier detection of AKI, determination of etiologies, and prediction of outcomes. However, the use of these new biomarkers may be limited due to reimbursement issues. In addition to the therapeutic role of furosemide in fluid balance, blood pressure control, and hypercalcemia management, Chawla et al. recommend the furosemide stress test (FST) as a tool to predict AKI progression. Designing a test that predicts the probability of AKI progression will help us make better decisions regarding the optimal timing of RRT initiation. In this study, we aimed to evaluate the feasibility of using the FST test in determining the progression of AKI in patients hospitalized in the intensive care unit and the need for RRT using the noninvasive procedure furosemide stress test.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Those who meet KDIGO AKI stage 1 and stage 2 criteria in the first 24 hours
Those with sufficient fluid volume (CVP≥6 cmH20)
Female and male patients over the age of 18 will be included in the study
Disqualifiers
Pregnant patients
Hospitalization due to intoxication
Liver or kidney transplant
Glomerular filtration rate below 30 ml/min/1.73m2
Trial design
Design model
Single group
Treatments tested in this trial
Furosemide
DrugFurosemide will be administered intravenously in the form of a push at a dose of 1 mg/kg to furosemide-naïve patients who meet the inclusion criteria and at a dose of 1.5 mg/kg to patients exposed to furosemide.
Treatment groups
140 Participants
are divided into 1 treatment groupGroup A: Furosemide stress test application in AKI stage 1-2 according to kdigo criteriaOther 1 intervention
Trial outcomes
Primary outcomes
1
Progression from AKI Stage 1-2 to Stage 3 within 14 days in patients who underwent furosemide stress test
Among the patients included in the study, within the first 24 hours following ICU admission, patients who have not used Furosemide within the last 7 days will be administered 1 mg/kg intravenously as a push for patients who have been exposed to furosemide, and 1.5 mg/kg for patients who have been exposed to furosemide. Patients who can excrete 200 ml or more urine within the first 2 hours after furosemide administration will be evaluated as having a positive furosemide stress test(FST). Our primary outcome is to determine how helpful it is in predicting progression from AKI stage 1-2 to AKI stage 3 within 14 days after the FST.
Time frame
14 days after FSTSecondary outcomes
1
Renal Replacement Therapy
Incidence of patients requiring initiation of CRRT based on clinical indications
Time frame
Within 14 days post-FST2
Persistent AKI
Proportion of patients whose AKI persists beyond 48 hours from the Furosemide Stress Test, as defined by KDIGO criteria.
Time frame
Up to 14 days post-FST3
Hospital Stay
Total number of days spent in the hospital following the Furosemide Stress Test.
Time frame
From date of FST until discharge or death (up to 90 days)4
Mortality
All-cause mortality rate recorded within 28 days after the FST.
Time frame
28 days post-FSTSponsors and contacts
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Source ClinicalTrials.gov