Furosemide stress test predicts acute kidney injury progression in intensive care unit

Abstract

Introduction: Clinical tools to predict acute kidney injury (AKI) in intensive care unit (ICU) are lacking. Objectives: This prospective study was conducted to assess the utility of furosemide stress test (FST) to predict AKI and its progression to severe stages and requirement of hemodialysis (HD). Patients and methods: Patients in AKI stage I or II were given a standardized dose of frusemide as per protocol. The study cohort included 62 patients. Response to FST was assessed by urine output (UOP) at 2 hours. Study patients were subsequently divided into two groups, those with UOP >200 mL (group A) and those with UOP <200 mL (group B). Results: Group A constituted 71% (n=44) of cases. Of them, 2 (4.54%) patients progressed to AKI Network (AKIN) stage III. Group B constituted 29% of cases (n=18). Of them, 12 (66%) cases progressed to AKIN stage III. In group A, 4.5% (n=2) of cases required HD. In comparison, 55% (n=10) of group B patients required HD during the hospital stay. Mortality rate was 6.8% (n=3) in group A and 33.3% (n=6) in group B. The duration of stay was more in the patients with UOP <200 mL group compared to UOP >200 mL group. Conclusion: FST may be a reliable predictor of AKI progression to severe stages and requirement of dialysis in ICUs.