Furosemide Stress Test

Hypothesis:  The kidney’s lack of response to a furosemide challenge can identify patients with severe tubular injury before it is clinically apparent.

Patients whose AKI progressed have significantly lower urine output following a furosemide stress test.  The ideal cutoff for predicting AKI progression was a urine volume <200mls (100ml/hr).  The sensitivity of this test is 87.1% and specificity is 84.1%

Standard high-dose furosemide stress test: (clinically euvolemic patients with early AKI)

  1. naive patients – 1mg/kg furosemide
  2. prior exposure – 1.5 mg/kg furosemide

References

Chawla, Lakhmir S et al. ‘Development And Standardization Of A Furosemide Stress Test To Predict The Severity Of Acute Kidney Injury’. Critical Care 17.5 (2013): R207. Web. 4 Oct. 2015.

Koyner, J. L. et al. ‘Furosemide Stress Test And Biomarkers For The Prediction Of AKI Severity’.Journal of the American Society of Nephrology 26.8 (2015): 2023-2031. Web. 4 Oct. 2015.

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