The prediction value of the furosemide stress test in the severity of early acute kidney injury complicated by septic shock

Zhao Dan; Liang Feng-ming; Dong Liang; Hui Jiao-jie

doi:10.3969/j.issn.1002-1949.2017.12.003

Abstract：Objective To investigate the prediction value of the furosemide stress test in the severity of early acute kidney injury (AKI) complicated by septic shock.Methods From February 2014 through December 2016,a total of 72 eligible patients who admitted to ICU and EICU in our hospital were enrolled in this prospective study.They were received a furosemide stress test (FST) (one-time dose of 1.0 or 1.5 mg/kg intravenous furosemide depending on prior furosemide-exposure)after adequate fluid resuscitation.The urine output following FST in each of the first 6 hours were recorded.The test was followed up for 28 days.According to stage 3 of AKI criteria,patients were divided into the progressor group and non-progressor group.The receiver operating characteristic curves were used to evaluate the prediction value of the furosemide stress test in the severity of acute kidney injury.Results Subjects with progressive AKI had significantly lower urine output following FST in each of the first 6 hours (P ＜ 0.05).The area under the receiver operator characteristic curves for the total urine output over the first 2 hours following FST to predict progression to stage 3 of AKI was 0.914 (95％ CI0.824 ～ 0.967),the sensitivity was 86.8％ and specificity was 88.2％ with a cutoff value of 170 mL.Age,APACHE Ⅱ score,blood lactate and urine output following FST in first 2 hours are the high risk factors affecting the prognosis (P ＜ 0.05).Conclusion The urine output following FST within the first 2 hours has a predictive value for in the severity of subjects with early AKI complicated by sepsis shock.Age,APACHE Ⅱ score,blood lactate and urine output following FST in first 2 hours are the high risk factors affecting the prognosis.