Furosemide Stress Test to Predict Successful Liberation From RRT

NCT ID: NCT05612490

Last Updated: 2025-08-12

Basic Information

• Recruitment Status: COMPLETED
• Total Enrollment: 52 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2023-01-17
• Study Completion Date: 2025-07-09

Brief Summary

The proposed study will evaluate if a standardised dose of furosemide administered in the 12 hours after RRT liberation can predict successful liberation in critically ill patients. The dose that will be administered is in accordance with the prescribing information.

Detailed Description

Response to furosemide administration is commonly used in clinical practice to assess a patient's potential for RRT liberation. However, this administration is not standardized and practices varies greatly. Rapid recognition of unsuccessful RRT liberation is crucial to avoid further complications such as fluid overload or acid-base and electrolyte disorders. The FST corresponds to the intravenous administration of 1 mg/kg (1.5 mg/kg in previously exposed patients) of furosemide and the assessment of resulting diuresis in the following two hours. FST is able to predict progression from AKI stage I and II to stage III with a high sensitivity (87.1%) and specificity (84.1%), area under the ROC curve 0.87. However, the ability of FST to predict RRT liberation has never been formally assessed.

Conditions

Acute Kidney Injury

Study Design

• Observational Model Type: CASE_ONLY
• Study Time Perspective: PROSPECTIVE

Study Groups

Critically ill patients undergoing RRT

Patients admitted to participating ICU and receiving renal replacement therapy.

Furosemide stress test

Intervention Type: DRUG

The FST corresponds to the intravenous single-dose administration of 1 mg/kg (1.5 mg/kg in previously exposed patients) of furosemide and the assessment of resulting diuresis in the following two hours. In the 12 hours following the first RRT liberation, a FST will be performed. The test will be considered positive if urinary output is ≥200 mL in the two hours following furosemide administration.

Interventions

Furosemide stress test

The FST corresponds to the intravenous single-dose administration of 1 mg/kg (1.5 mg/kg in previously exposed patients) of furosemide and the assessment of resulting diuresis in the following two hours. In the 12 hours following the first RRT liberation, a FST will be performed. The test will be considered positive if urinary output is ≥200 mL in the two hours following furosemide administration.

Intervention Type: DRUG

Other Intervention Names

FST

Eligibility Criteria

Inclusion Criteria

• Receiving continuous or intermittent RRT for AKI
• Having an indwelling urinary catheter
• Clinical decision by physician in charge to attempt RRT liberation
• lnformed consent signed by the patient himself / legal representative or authorization received from independent physician

Exclusion Criteria

• Electrolyte disturbances or hemodynamic instability precluding the use of furosemide (sodium > 155 mmol/L and/or potassium < 3.0 mmol/L and/or metabolic alkalosis > 7.50 and/or mean arterial pressure < 60 mmHg)
• Known furosemide allergy
• Urine output ≥ 100 mL/h for at least two hours
• Recent (< 24 hours) FST
• Known end-stage chronic renal disease at ICU admission
• Withdrawal of life support decision taken before inclusion
• Patient already participating in conflicting research study
• Patient having already participated in this current study
• Any other contraindication of furosemide

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Centre Hospitalier Universitaire Vaudois

OTHER

Sponsor Role: lead

Responsible Party

Antoine Schneider

Doctor

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Antoine Schneider, MD PhD

Role: PRINCIPAL_INVESTIGATOR

Centre Hospitalier Universitaire Vaudois

Locations

Centre Hospitalier Universitaire Vaudois

Lausanne, Canton of Vaud, Switzerland

Countries

Switzerland

References

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.

Reference Type: BACKGROUND

PMID: 24053972 (View on PubMed)

Other Identifiers

2022-01826

Identifier Type: -

Identifier Source: org_study_id