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Medicina crítica (Colegio Mexicano de Medicina Crítica)

versão impressa ISSN 2448-8909

Resumo

RIVERA SOLIS, Gerardo et al. Furosemide stress test to predict success or failure to remove continuos slow renal replacement therapy in acute renal injury. Med. crít. (Col. Mex. Med. Crít.) [online]. 2018, vol.32, n.2, pp.85-92. ISSN 2448-8909.

Introduction:

Acute kidney injury (AKI) is a frequent organ failure in the patient in shock; continuous slow renal replacement therapy (CSRRT) is an extracorporeal support that modifies the patient’s prognosis; the criteria for its initiation as well as for retirement are not completely generalized. The furosemide stress test may be a prognostic marker in patients in whom renal support is withdrawn.

Material and methods:

Prospective, observational, analytical and cross-sectional study. Patients with AKI requiring CSRRT were included; 1 mg/kg of furosemide was given to the patients in whom it was decided to withdraw, uresis was quantified at 2, 6 and 24 hours and biochemical variables of renal function were measured. Patients who did not merit CSRRT again during the next seven days were considered successful to the test.

Results:

Thirty-one patients connected to TRRLC within the Intensive care unit (ICU), seven were removed for dying within their first day of ICU stay, including a total of twenty four for their study. 45.8% were successful at withdrawal from CSRRT. The 200 mL uresis after the furosemide test has a sensitivity of 64%, a specificity of 100% to predict success on withdrawal and recovery of renal function, with an area under the curve of 0.944.

Conclusion:

The presence of 200 mL uresis at 2 hours after administration of furosemide is useful as a predictor of successful withdrawal of TRRLC and recovery of renal function.

Palavras-chave : Acute renal injury; continuous slow renal replacement therapy; furosemide test.

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