Furosemide Stress Test to Predict Successful Liberation From RRT (FST-RRT)

Evaluation of the Furosemide Stress Test to Predict Successful Liberation From Renal Replacement Therapy in Critically Ill Patients

The proposed study will evaluate if a standardised dose of furosemide administered in the 12 hours after RRT liberation can predict successful liberation in critically ill patients. The dose that will be administered is in accordance with the prescribing information.

Study Overview

• Status: Completed
• Conditions: Acute Kidney Injury
• Intervention / Treatment: Drug: Furosemide stress test

Detailed Description

Response to furosemide administration is commonly used in clinical practice to assess a patient's potential for RRT liberation. However, this administration is not standardized and practices varies greatly. Rapid recognition of unsuccessful RRT liberation is crucial to avoid further complications such as fluid overload or acid-base and electrolyte disorders. The FST corresponds to the intravenous administration of 1 mg/kg (1.5 mg/kg in previously exposed patients) of furosemide and the assessment of resulting diuresis in the following two hours. FST is able to predict progression from AKI stage I and II to stage III with a high sensitivity (87.1%) and specificity (84.1%), area under the ROC curve 0.87. However, the ability of FST to predict RRT liberation has never been formally assessed.

• Study Type: Observational
• Enrollment (Actual): 52

Contacts and Locations

Study Locations

• Switzerland
  • Vaud
    • Lausanne, Vaud, Switzerland, 1011
      • Centre Hospitalier Universitaire Vaudois

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No

• Sampling Method: Probability Sample

Study Population

ICU patients receiving continuous RRT for AKI

Description

Inclusion Criteria:

• Receiving continuous or intermittent RRT for AKI
• Having an indwelling urinary catheter
• Clinical decision by physician in charge to attempt RRT liberation
• lnformed consent signed by the patient himself / legal representative or authorization received from independent physician

Exclusion Criteria:

• Electrolyte disturbances or hemodynamic instability precluding the use of furosemide (sodium > 155 mmol/L and/or potassium < 3.0 mmol/L and/or metabolic alkalosis > 7.50 and/or mean arterial pressure < 60 mmHg)
• Known furosemide allergy
• Urine output ≥ 100 mL/h for at least two hours
• Recent (< 24 hours) FST
• Known end-stage chronic renal disease at ICU admission
• Withdrawal of life support decision taken before inclusion
• Patient already participating in conflicting research study
• Patient having already participated in this current study
• Any other contraindication of furosemide

Study Plan

How is the study designed?

Design Details

• Observational Models: Case-Only
• Time Perspectives: Prospective

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort

Intervention / Treatment

Critically ill patients undergoing RRT; Patients admitted to participating ICU and receiving renal replacement therapy.

Drug: Furosemide stress test; The FST corresponds to the intravenous single-dose administration of 1 mg/kg (1.5 mg/kg in previously exposed patients) of furosemide and the assessment of resulting diuresis in the following two hours. In the 12 hours following the first RRT liberation, a FST will be performed. The test will be considered positive if urinary output is ≥200 mL in the two hours following furosemide administration.; Other Names: FST

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Successful liberation of RRT within 72 hours after FST	No renal replacement therapy administered	within 72 hours

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Successful liberation of RRT at ICU discharge	No renal replacement therapy administered	At time of ICU discharge, assessed up to 90 days post inclusion
Successful liberation of RRT at hospital discharge	No renal replacement therapy administered	At time of hospital discharge, assessed up to 90 days post inclusion
Adverse events associated with the intervention	(electrolyte disturbances, hypotension)	within 6 hours

Collaborators and Investigators

• Sponsor: Centre Hospitalier Universitaire Vaudois
• Investigators: Principal Investigator: Antoine Schneider, MD PhD, Centre Hospitalier Universitaire Vaudois

Publications and helpful links

General Publications

• Chawla LS, Davison DL, Brasha-Mitchell E, Koyner JL, Arthur JM, Shaw AD, Tumlin JA, Trevino SA, Kimmel PL, Seneff MG. Development and standardization of a furosemide stress test to predict the severity of acute kidney injury. Crit Care. 2013 Sep 20;17(5):R207. doi: 10.1186/cc13015.

Study record dates

Study Major Dates

• Study Start (Actual): January 17, 2023
• Primary Completion (Actual): June 4, 2025
• Study Completion (Actual): July 9, 2025

Study Registration Dates

• First Submitted: November 3, 2022
• First Submitted That Met QC Criteria: November 9, 2022
• First Posted (Actual): November 10, 2022

Study Record Updates

• Last Update Posted (Actual): August 12, 2025
• Last Update Submitted That Met QC Criteria: August 11, 2025
• Last Verified: August 1, 2025

More Information

Terms related to this study

• Keywords: Renal replacement therapy; Acute Kidney Injury; Furosemide Stress Test
• Additional Relevant MeSH Terms: Urogenital Diseases; Male Urogenital Diseases; Kidney Diseases; Urologic Diseases; Female Urogenital Diseases; Female Urogenital Diseases and Pregnancy Complications; Renal Insufficiency; Acute Kidney Injury; Physiological Effects of Drugs; Molecular Mechanisms of Pharmacological Action; Membrane Transport Modulators; Diuretics; Natriuretic Agents; Sodium Potassium Chloride Symporter Inhibitors; Furosemide
• Other Study ID Numbers: 2022-01826

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: Yes
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No