Response to different furosemide doses predicts AKI progression in ICU patients with elevated plasma NGAL levels
| Autor: | Tetsushi Yamashita, Ryo Matsuura, Kengo Mayumi, Kohei Yoshimoto, Yohei Komaru, Eisei Noiri, Rei Isshiki, Yoshifumi Hamasaki, Yoshihisa Miyamoto, Naoto Morimura, Masaomi Nangaku, Kent Doi, Teruhiko Yoshida |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Population 030232 urology & nephrology Urology 030204 cardiovascular system & hematology Critical Care and Intensive Care Medicine urologic and male genital diseases law.invention 03 medical and health sciences 0302 clinical medicine Bolus (medicine) law Anesthesiology medicine Intensive care unit education Diuretics education.field_of_study Progression business.industry Research lcsh:Medical emergencies. Critical care. Intensive care. First aid Area under the curve Acute kidney injury Furosemide lcsh:RC86-88.9 medicine.disease female genital diseases and pregnancy complications Biomarker (medicine) business Biomarkers medicine.drug |
| Zdroj: | Annals of Intensive Care Annals of Intensive Care, Vol 8, Iss 1, Pp 1-10 (2018) |
| ISSN: | 2110-5820 |
| Popis: | Background Furosemide responsiveness (FR) is determined by urine output after furosemide administration and has recently been evaluated as a furosemide stress test (FST) for predicting severe acute kidney injury (AKI) progression. Although a standardized furosemide dose is required for FST, variable dosing is typically employed based on illness severity, including renal dysfunction in the clinical setting. This study aimed to evaluate whether FR with different furosemide doses can predict AKI progression. We further evaluated the combination of an AKI biomarker, plasma neutrophil gelatinase-associated lipocalin (NGAL), and FR for predicting AKI progression. Results We retrospectively analyzed 95 patients who were treated with bolus furosemide in our medical–surgical intensive care unit. Patients who had already developed AKI stage 3 were excluded. A total of 18 patients developed AKI stage 3 within 1 week. Receiver operating curve analysis revealed that the area under the curve (AUC) values of FR and plasma NGAL were 0.87 (0.73–0.94) and 0.80 (0.67–0.88) for AKI progression, respectively. When plasma NGAL level was 142 ng/mL. FR was associated with AUC of 0.84 (0.67–0.94) for AKI progression in this population with high NGAL levels. Conclusions Although different variable doses of furosemide were administered, FR revealed favorable efficacy for predicting AKI progression even in patients with high plasma NGAL levels. This suggests that a combination of FR and biomarkers can stratify the risk of AKI progression in a clinical setting. Electronic supplementary material The online version of this article (10.1186/s13613-018-0355-0) contains supplementary material, which is available to authorized users. |
| Databáze: | OpenAIRE |
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