呋塞米负荷试验对急性肾损伤患者启动肾脏替代治疗的预测价值

doi:10.3969/j.issn.1002-1949.2018.07.005

Chinese Journal of Critical Care Medicine

2018, Vol. 38

Issue (7): 586-589 DOI: 10.3969/j.issn.1002-1949.2018.07.005

Predictive value of furosemide stress test in starting renal replacement therapy of patients with acute kidney injury

Dou Zhi-min, Li Hong, Zhu Lei, Li Bin, Liu Jian

Department of Critical Care Medicine, the First Hospital of Lanzhou University, Lanzhou 730000, China

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Abstract Objective To investigate the predictive value of furosemide stress test (FST) in starting renal replacement therapy (RRT) of patients with acute kidney injury (AKI). Methods One hundred and thirty-eight patients with AKI admitted to the Department of Critical Care Medicine of the First Hospital of Lanzhou University were included. FST, that was furosemide was intravenously given to the patients and then the urine output of the second hour (FST-UO2h) was recorded, were taken before RRT. The renal function changes and mortality of included patients were observed after RRT. All patients were divided into progressive group and non-progressive group. With FST-UO2hless than or equal to 200 mL as FST negative, the ROC curve was used to evaluate the specificity and sensitivity of FST-UO2hto predict the deterioration of renal function after RRT. Results There was no significant difference in the age, APACHE Ⅱ score, and SOFA score before RRT between the progressive group and the non-progressive group. The proportion of KDIGO Ⅱ patients in the progressive group were higher than those in the non-progressive group, and the length of stay and the mortality of 28 d were also higher than those in the non-progressive group. The area under the ROC curve (AUC) of FST-UO2h(0.76±0.07, P=0.01) in predicting the function deterioration after RRT was significantly higher than the AUC of sCr and NGAL (0.55±0.08, P=0.48 and 0.63±0.07, P=0.08 respectively). Conclusion If FST of patients with AKI is negative, suggesting that the renal function may be worsen, the RRT should be initiated as soon as possible.

Key words： Furosemide stress test (FST) Renal replacement therapy（RRT） Acute kidney injury (AKI) Predictive value

Corresponding Authors: Li Bin, E-mail:lynd0001@163.com

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Cite this article:

Dou Zhi-min,Li Hong,Zhu Lei, et al. Predictive value of furosemide stress test in starting renal replacement therapy of patients with acute kidney injury[J]. Chinese Journal of Critical Care Medicine, 2018, 38(7): 586-589.

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http://www.cnemergency.org.cn/EN/10.3969/j.issn.1002-1949.2018.07.005 OR http://www.cnemergency.org.cn/EN/Y2018/V38/I7/586

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