Critical Illness Clinical Trial
Official title:
Performance of Diuretic Stress Test in Predicting Short Term Renal Recovery in Oliguric Critically-ill Patients
Acute kidney injury (AKI) is a common disorder and associated with high morbidity and
mortality. However, distinguishing transient AKI from persistent AKI may help in
individualizing treatment and limit short and long term consequences of AKI. Previous studies
suggested usual urinary indices to perform poorly for separating transient from persistent
AKI in an unselected population of critically ill patients. The recent KDIGO (Kidney Disease
Improving Global Outcomes) guidelines underlined the need for additional strategies in
estimating renal short term prognosis.
Recently, a Furosemide stress test (FST) was validated in a cohort of unselected critically
ill patients. This stress test performance was found to be good in predicting capacity to
identify those patients that will progress to advanced stage AKI. Additionally, FST
performance was higher than those of usual renal biomarker. The limited sample size of this
preliminary study however precluded adjustment for usual confounders including oliguria.
The primary objective of this study is to assess diagnostic performance of FST in
differentiating transient and persistent AKI. Secondary objectives are to assess diagnostic
performance of FST in predicting need for renal replacement therapy, and to confirm FST
results after adjustment for confounders.
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