Protocol Based-furosemide Stress Test Versus Standard Care to Evaluate Renal Recovery During Continuous Renal Replacement Therapy

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

PHASE4

Total Enrollment

40 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-01-01

Study Completion Date

2024-06-07

Brief Summary

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Currently, continuous renal replacement therapy (CRRT) is the main modality for renal support in critically ill patients with hemodynamic instability. Most studies have investigated the timing of RRT initiation. However, prolonged CRRT demonstrated the association of many unexpected events, such as catheter-related complications, catheter-related blood stream infection, hypotension, hypothermia, tachycardia, and atrial fibrillation. Up to now, there is a lack of evidence regarding the timing of withholding CRRT. The furosemide stress test (FST) is a tool that is easy to use and has more availability. The investigators aimed to apply FST to evaluate renal recovery compared with standard treatment in critically ill patients undergoing CRRT.

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Detailed Description

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Conditions

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Acute Kidney Injury

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Protocol based-furosemide stress test

Furosemide at 1.5 mg/kg intravenously

Group Type EXPERIMENTAL

Furosemide Injection

Intervention Type DRUG

After taking furosemide at 1.5 mg/kg intravenously, if the urine output exceeds 200 mL within 2 hours, the patients are going to withhold CRRT. But if there is no response, the titration of furosemide to 2.5 mg/kg and 3.5 mg/kg every 6 hours is scheduled according to the urine output \>200 mL in 2 hours (not exceeding 250 mg).

Standard care

Standard CRRT care without furosemide use during treatment.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Furosemide Injection

After taking furosemide at 1.5 mg/kg intravenously, if the urine output exceeds 200 mL within 2 hours, the patients are going to withhold CRRT. But if there is no response, the titration of furosemide to 2.5 mg/kg and 3.5 mg/kg every 6 hours is scheduled according to the urine output \>200 mL in 2 hours (not exceeding 250 mg).

Intervention Type DRUG

Other Intervention Names

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Furosemide stress test

Eligibility Criteria

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Inclusion Criteria

* Adult 20 year of age or older
* Acute kidney injury (AKI) stage 3 according to Kidney Disease Improving Global Outcomes (KDIGO) classification with oliguria (urine \<400 ml/day)
* Initiate CRRT in ICU (medical ICU, surgical ICU, cardiac care unit) for at least 48 hours (time for initiation and modality of CRRT can adjust by clinician)

Exclusion Criteria

* Use any inotropic drug (norepinephrine, epinephrine, dopamine, dobutamine)
* Blood urea nitrogen (BUN) \>80 mg/dL
* Serum K \<3.5 or \>5 mmol/L
* Arterial potential of Hydrogen (pH) \<7.3
* Serum bicarbonate (HCO3) \<15 mmol/L
* Urine volume \<400 or \>2,100 mL/day
* Urine creatinine clearance (CrCl) at 6 hours \>20 mL/min
* Previous chronic kidney disease (CKD) stage 5 or estimated glomerular filtration rate (eGFR) \<15 mL/min/1.73 m2
* Previous RRT within 14 days
* Kidney transplantation
* Obstructive etiology for AKI
* Toxin/drug that necessitates RRT
* Allergy to furosemide
* Moribund with expected death within 24 hours
* Pregnancy

Minimum Eligible Age

20 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No