The Role of Furosemide Stress Test in the Intensive Care Clinic

NCT06765031 | Recruiting

• 1 other identifier: AEŞH-BADEK-2024-1037
• Study Type: interventional
• Target: 140
• Locations: 1 country
• Sites: 1

Brief Summary

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.

Conditions

Akut Kidney Injury

Keywords

akut kidney injury; furosemide stres test; continuous renal replasman terapy

Outcome Measures

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.

  14 days after FST

Secondary Outcomes (4)

• Renal Replacement Therapy

  Within 14 days post-FST

• Persistent AKI

  Up to 14 days post-FST

• Hospital Stay

  From date of FST until discharge or death (up to 90 days)

• Mortality

  28 days post-FST

Study Arms (1)

Furosemide stress test application in AKI stage 1-2 according to kdigo criteria

OTHER

Among the patients included in the study, furosemide will be administered intravenously as a push at a dose of 1 mg/kg to patients who have not used furosemide in the last 7 days within the first 24 hours following ICU admission, and at a dose of 1.5 mg/kg to patients who have been exposed to furosemide. Patients who can pass 200 ml or more of urine within the first 2 hours after furosemide administration will be evaluated as having a positive furosemide stress test.

Drug: Furosemide

Interventions

Furosemide DRUG

Furosemide 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.

Furosemide stress test application in AKI stage 1-2 according to kdigo criteria

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• 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

You may not qualify if:

• Pregnant patients
• Hospitalization due to intoxication
• Liver or kidney transplant
• Glomerular filtration rate below 30 ml/min/1.73m2
• Active bleeding
• Patients with obstructive uropathy
• Patients in need of urgent RRT (K≥6.6 meq/L, pH\<7.15, pulmonary edema due to fluid overload, uremic complications)
• Patients evaluated as KDIGO AKI stage 3
• Patients who have received RRT in the last 30 days
• Patients with CKD diagnosis
• Patients with pulmonary embolism
• Hypoalbuminemia≥2.5 g/dl,
• Patients receiving cephalosporin treatment will be excluded from the sample.

Sponsors & Collaborators

• Gulhane Training and Research Hospital: lead

Study Sites (1)

Gulhane Training and Research Hospital

Ankara, keçiören, 06010, Turkey (Türkiye)

RECRUITING

Related Publications (2)

• Chawla LS, Davison DL, Brasha-Mitchell E, Koyner JL, Arthur JM, Shaw AD, Tumlin JA, Trevino SA, Kimmel PL, Seneff MG. Development and standardization of a furosemide stress test to predict the severity of acute kidney injury. Crit Care. 2013 Sep 20;17(5):R207. doi: 10.1186/cc13015.

  PMID: 24053972 RESULT

• Gibney N, Hoste E, Burdmann EA, Bunchman T, Kher V, Viswanathan R, Mehta RL, Ronco C. Timing of initiation and discontinuation of renal replacement therapy in AKI: unanswered key questions. Clin J Am Soc Nephrol. 2008 May;3(3):876-80. doi: 10.2215/CJN.04871107. Epub 2008 Mar 5.

  PMID: 18322044 RESULT

MeSH Terms

Interventions

Furosemide

Intervention Hierarchy (Ancestors)

Sulfanilamides; Sulfonamides; Amides; Organic Chemicals; Aniline Compounds; Amines; Sulfones; Sulfur Compounds

Study Officials

• gürhan t taşkın, Associate Professor

  Gulhane Training and Research Hospital

  STUDY DIRECTOR

Central Study Contacts

mete e erdemir, intensive care specialist

CONTACT

+905066321175; meteerdemir@hotmail.com

gürhan T taşkın, Associate Professor

CONTACT

+905057202781; drgurhantaskin@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: SCREENING
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER GOV
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: principal investigator

Study Record Dates

• First Submitted: December 19, 2024
• First Posted: January 9, 2025
• Study Start: November 1, 2024
• Primary Completion: March 31, 2026
• Study Completion: March 31, 2026
• Last Updated: January 12, 2026

Record last verified: 2025-12

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP, CSR

Locations

TU (1)