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Furosemide Stress Test and Renal Resistive Index for Prediction of Severity of Acute Kidney Injury in Sepsis

Introduction The furosemide stress test (FST) predicts the severity and the need for renal replacement therapy (RRT) in patients with sepsis-associated acute kidney injury (S-AKI). The renal resistive index (RRI) indicates renal vascular resistance. Objectives The primary objective was to find the c...

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Autores principales: Das, Pravin K, Maurya, Sudeep K, Nath, Soumya Sankar, Kumar, Tushant, Rao, Namrata, Shrivastava, Neha
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10543092/
https://www.ncbi.nlm.nih.gov/pubmed/37791174
http://dx.doi.org/10.7759/cureus.44408
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author Das, Pravin K
Maurya, Sudeep K
Nath, Soumya Sankar
Kumar, Tushant
Rao, Namrata
Shrivastava, Neha
author_facet Das, Pravin K
Maurya, Sudeep K
Nath, Soumya Sankar
Kumar, Tushant
Rao, Namrata
Shrivastava, Neha
author_sort Das, Pravin K
collection PubMed
description Introduction The furosemide stress test (FST) predicts the severity and the need for renal replacement therapy (RRT) in patients with sepsis-associated acute kidney injury (S-AKI). The renal resistive index (RRI) indicates renal vascular resistance. Objectives The primary objective was to find the correlation between FST and RRI in S-AKI. The secondary objectives were to evaluate the role of FST and RRI on the progression of S-AKI. Methods A total of 154 consenting adult patients with S-AKI were administered FST. Renal echography was performed within the first 12 hours of admission, and RRI was calculated. The patients were grouped either into progressors or non-progressors to AKI-KDIGO stage 3. Results Of the patients who had RRI at Day 1 less than 0.73, 60% recovered, 34.3% needed RRT, and 35.5% died, whereas in those who had RRI at Day 1 greater than 0.73, only 22% recovered, 46.6% required RRT, and 51.6% died. RRI value of 0.73 predicted the need for RRT with a sensitivity of 35.1%, specificity of 80.4% and accuracy of 69.1%. The highest number of patients of KDIGO stage 3 (50%), followed by stage 2 (28.1%) and stage 1 (21.9%), presented technical difficulties in measuring the RRI. Conclusion FST is an economical and easily administered test to assess renal tubular function and can predict the occurrence and progression of S-AKI. RRI is a modest marker for predicting the need for RRT or persistent AKI.
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spelling pubmed-105430922023-10-03 Furosemide Stress Test and Renal Resistive Index for Prediction of Severity of Acute Kidney Injury in Sepsis Das, Pravin K Maurya, Sudeep K Nath, Soumya Sankar Kumar, Tushant Rao, Namrata Shrivastava, Neha Cureus Internal Medicine Introduction The furosemide stress test (FST) predicts the severity and the need for renal replacement therapy (RRT) in patients with sepsis-associated acute kidney injury (S-AKI). The renal resistive index (RRI) indicates renal vascular resistance. Objectives The primary objective was to find the correlation between FST and RRI in S-AKI. The secondary objectives were to evaluate the role of FST and RRI on the progression of S-AKI. Methods A total of 154 consenting adult patients with S-AKI were administered FST. Renal echography was performed within the first 12 hours of admission, and RRI was calculated. The patients were grouped either into progressors or non-progressors to AKI-KDIGO stage 3. Results Of the patients who had RRI at Day 1 less than 0.73, 60% recovered, 34.3% needed RRT, and 35.5% died, whereas in those who had RRI at Day 1 greater than 0.73, only 22% recovered, 46.6% required RRT, and 51.6% died. RRI value of 0.73 predicted the need for RRT with a sensitivity of 35.1%, specificity of 80.4% and accuracy of 69.1%. The highest number of patients of KDIGO stage 3 (50%), followed by stage 2 (28.1%) and stage 1 (21.9%), presented technical difficulties in measuring the RRI. Conclusion FST is an economical and easily administered test to assess renal tubular function and can predict the occurrence and progression of S-AKI. RRI is a modest marker for predicting the need for RRT or persistent AKI. Cureus 2023-08-30 /pmc/articles/PMC10543092/ /pubmed/37791174 http://dx.doi.org/10.7759/cureus.44408 Text en Copyright © 2023, Das et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Internal Medicine
Das, Pravin K
Maurya, Sudeep K
Nath, Soumya Sankar
Kumar, Tushant
Rao, Namrata
Shrivastava, Neha
Furosemide Stress Test and Renal Resistive Index for Prediction of Severity of Acute Kidney Injury in Sepsis
title Furosemide Stress Test and Renal Resistive Index for Prediction of Severity of Acute Kidney Injury in Sepsis
title_full Furosemide Stress Test and Renal Resistive Index for Prediction of Severity of Acute Kidney Injury in Sepsis
title_fullStr Furosemide Stress Test and Renal Resistive Index for Prediction of Severity of Acute Kidney Injury in Sepsis
title_full_unstemmed Furosemide Stress Test and Renal Resistive Index for Prediction of Severity of Acute Kidney Injury in Sepsis
title_short Furosemide Stress Test and Renal Resistive Index for Prediction of Severity of Acute Kidney Injury in Sepsis
title_sort furosemide stress test and renal resistive index for prediction of severity of acute kidney injury in sepsis
topic Internal Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10543092/
https://www.ncbi.nlm.nih.gov/pubmed/37791174
http://dx.doi.org/10.7759/cureus.44408
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