2016, Number 4
PDF size: 184.21 Kb.
ABSTRACTIntroduction: Several factors are associated with the presence of acute kidney injury (AKI) in critical ill patients, that is the reason because many authors have attempted to develop diagnostic tests to determine the performance and behavior of renal function. The furosemide stress test (FST) is an easy and accessible strategy in our environment for this purpose. This study evaluated the diagnostic performance of the FST in the development of AKI stage 3.
Methods: Through a prospective cohort (September 2014 to September 2015) we evaluated patient whit AKI stages 1 and 2; previously to the FST, volume status was determined by focused ultrasound and proceeded to administer 1 mg/kg single dose of furosemide. Positive test was defined as a urine output › 200 ml in two hours later. We followed for six hours diuresis, progression to KDIGO 3, the need for renal replacement therapy (RRT) and mortality.
Results: 20 patients with AKI KDIGO 1 and 2 were identified, for the analysis they were classified in responders (R) and non-responders group (NR) to the test. NR group was formed by 4 patients who represented a correlation with progression KDIGO 3 and RRT, p = 0.003 and p = 0.013 respectively; it was documented an area under the curve (ROC) of 0.83 (95% CI 0.60 to 0.96) and 0.84 (95 % 0.61 to 0.96), no association was found with mortality.
Conclusions: FST adequately predicts the behavior of renal function; this is consistent with other studies but a bigger study population is required to corroborate the accuracy of the data mentioned above.
Vincent JL, Moreno R, Takala J, Willatts S, De Mendoça A, Bruining H. The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. On behalf of the Working Group on Sepsis-Related Problems of the European Society of Intensive Care Medicine. Intensive Care Med. 1996;22:707-710.