Clinical trial NCT06229990: Protocol Based-furosemide Stress Test Versus Standard Care to Evaluate Renal Recovery During Continuous Renal Replacement Therapy
Official title: Protocol Based-furosemide Stress Test Versus Standard Care to Evaluate Renal Recovery During Continuous Renal Replacement Therapy: A Randomized Controlled Trial
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: PHASE4
Conditions: Acute Kidney Injury
Keywords: Acute kidney injury
Continuous renal replacement therapy
Furosemide stress test
Critical care
CRRT
Lead sponsor: Chiang Mai University
Sponsor class: OTHER
First posted: 2024-01-29
Enrollment: 40
Sex: ALL
Minimum age (years): 20
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: Currently, continuous renal replacement therapy (CRRT) is the main modality for renal support in critically ill patients with hemodynamic instability. Most studies have investigated the timing of RRT initiation. However, prolonged CRRT demonstrated the association of many unexpected events, such as catheter-related complications, catheter-related blood stream infection, hypotension, hypothermia, tachycardia, and atrial fibrillation. Up to now, there is a lack of evidence regarding the timing of withholding CRRT. The furosemide stress test (FST) is a tool that is easy to use and has more availability. The investigators aimed to apply FST to evaluate renal recovery compared with standard treatment in critically ill patients undergoing CRRT.


Eligibility criteria: Inclusion Criteria:

* Adult 20 year of age or older
* Acute kidney injury (AKI) stage 3 according to Kidney Disease Improving Global Outcomes (KDIGO) classification with oliguria (urine \<400 ml/day)
* Initiate CRRT in ICU (medical ICU, surgical ICU, cardiac care unit) for at least 48 hours (time for initiation and modality of CRRT can adjust by clinician)

Exclusion Criteria:

* Use any inotropic drug (norepinephrine, epinephrine, dopamine, dobutamine)
* Blood urea nitrogen (BUN) \>80 mg/dL
* Serum K \<3.5 or \>5 mmol/L
* Arterial potential of Hydrogen (pH) \<7.3
* Serum bicarbonate (HCO3) \<15 mmol/L
* Urine volume \<400 or \>2,100 mL/day
* Urine creatinine clearance (CrCl) at 6 hours \>20 mL/min
* Previous chronic kidney disease (CKD) stage 5 or estimated glomerular filtration rate (eGFR) \<15 mL/min/1.73 m2
* Previous RRT within 14 days
* Kidney transplantation
* Obstructive etiology for AKI
* Toxin/drug that necessitates RRT
* Allergy to furosemide
* Moribund with expected death within 24 hours
* Pregnancy

Primary outcomes:
measure: % of patients with Renal recovery
timeFrame: 5 days
Secondary outcomes:
measure: % of patients with Mortality
timeFrame: 28 days
measure: RRT free days
timeFrame: 28 days
measure: Day of Hospitalization
timeFrame: 28 days
measure: Ventilator-free day
timeFrame: 28 days
measure: % of complication
timeFrame: 28 days
measure: Cost of RRT during hospitalization
timeFrame: 28 days
Other outcomes:
Locations:
city: Chiang Mai
country: Thailand
facility: Chiang Mai University
Study officials:
References:
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