FURosemide Stress Test to Predict Need of Renal Replacement THERapy in Ischemic Acute Tubular Necrosis in ICU

• Status: Terminated
• Trial end date: 2020-12-07
• Target enrollment: 0
• Participant gender: All

Summary

Ischemic acute tubular necrosis (ATN) is one of the main cause of acute kidney injury (AKI) in intensive care units (ICU). Sepsis and cardio-pulmonary bypass (CPB) are major providers. There is no validated tool to predict the evolution of AKI is ICU. Furosemide Stress Test (FST) may predict evolution of ATN-related AKI outside ICU in terms of progressive AKI, need for renal replacement therapy (RRT) or inpatient mortality with improved performance comparing to biomarkers. FST has not been validated in a prospective cohort in ICU in the settings of ischemic ATN. FURTHER aim to determine whether FST would be a useful tool to identify patients with slight to moderate AKI (KDIGO stage 1 and 2) who will evolve towards need for RRT following AKIKI (The Artificial Kidney Initiation in Kidney Injury ) delayed initiation criteria.

• Phase: Phase 4
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: Assistance Publique - Hôpitaux de Paris
• Treatments: Furosemide

Criteria

Inclusion Criteria:

• Age over 18 years old

• Hospitalized in ICU at day of inclusion

• Diagnosis of sepsis defined as proven or suspected infection and increase of the SOFA (Sequential Organ Failure Assessment) score by 2 points or more compared to basal OR Cardiothoracic surgery with CBP (Cardiopulmonary bypass) within 72 hours before inclusion

• Adequate cardiac output and volemia assessed by cardiac ultrasound, venous saturation in Oxygen (ScVO2) or ΔPP

• Hemodynamic stabilization : stable norepinephrine dosage (or <20% variations) with no vascular filling during the last 3 hours

• AKI stage I or II in KDIGO classification

Exclusion Criteria:

• Chronic Kidney Disease with glomerular filtration rate ≤ 30 ml/mn/1,73m2

• Obstructive AKI

• AKI stage III in KDIGO classification

• Known allergy to loop diuretics

• Contraindications to Furosemide

• FST not feasible within 12 hours of eligibility

• Previous AKI during the same hospitalization

• Pregnancy or breastfeeding women

• Subject under a legal protective measure

• No affiliation to a social regime or CMU