Protocol Based-furosemide Stress Test Versus Standard Care to Evaluate Renal Recovery During Continuous Renal Replacement Therapy (PAUSE-CRRT)

Chiang Mai University

Status and phase: Enrolling; Phase 4

Conditions: Acute Kidney Injury

Treatments: Drug: Furosemide Injection

Study type: Interventional

Funder types: Other

Identifiers

NCT06229990

MED-2566-0034

Details and patient eligibility

About

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.

Enrollment: 40 estimated patients

Sex: All

Ages: 20+ years old

Volunteers: No Healthy Volunteers

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

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Quadruple Blind

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40 participants in 2 patient groups

Protocol based-furosemide stress test

Experimental group

Description:

Furosemide at 1.5 mg/kg intravenously

Treatment:

Drug: Furosemide Injection

Standard care

No Intervention group

Description:

Standard CRRT care without furosemide use during treatment.