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2017, Number 4

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Rev Hosp Jua Mex 2017; 84 (4)

Comparison of a furosemide stress test and biomarkers for the prediction of acute kidney injury

Pérez-Cruz E, Monroy-Chargoy A, Conde-Mercado JM, Méndez-Calderillo E

Language: Spanish
References: 35
Page: 196-202
PDF size: 204.55 Kb.


ABSTRACT

Background: Currently we have not an early marker to determine the progression of acute kidney injury (AKI) and the requirement for renal replacement therapy. The aim of this study was to compare the sensitivity (S) and specificity (E) of serum biomarkers versus furosemide stress test in patients with AKI. Material and methods: Prospective, clinical study conducted from December 2016 to March 2017. All patients between 18 and 65 years with diagnosis of AKI AKIN 1 and 2 were included. Serum creatinine was determined (at the beginning and at 72 hours), cystatin C was measured, and a furosemide stress test was made. Results: The early diagnostic test that had a greater significance with respect to the others for the prediction of the progression of AKI was the stress test with furosemide. Thirty-five patients were included, 71.4% men and 28.6% women, with a median age of 45 ± 12.1 years. The sensitivity and specificity of serum creatinine at 72 hours to predict the progression of AKI was 64.3% and 95.2%, respectively (χ2 = 0.001); in relation to the prediction of the need for renal replacement therapy, the sensitivity was 75 % and the specificity, 85.2% (χ2 = 0.001). The furosemide stress test showed a sensitivity of 57% and specificity of 95.2% (χ2 = 0.001); regarding the prediction to receive renal replacement therapy, it had a sensitivity and specificity of 62.5% and 85.2%, respectively (χ2 = 0.007). Conclusion: The determination of serum creatinine at 72 hours showed adequate sensitivity and specificity, as did the furosemide stress test; however, the latter is more useful for predicting early progression of AKI and the requirement of renal replacement therapy.


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