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10.1186/s13054-018-2021-1 http://scihub22266oqcxt.onion/10.1186/s13054-018-2021-1 C5909278!5909278 !29673370     free     free     free Warning: file_get_contents(https://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=29673370 &cmd=llinks): Failed to open stream: HTTP request failed! 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Early versus standard initiation of renal replacement therapy in furosemide stress test non-responsive acute kidney injury patients (the FST trial) |pdf=|usr=}}{{29673370 }} gab.com Text Early versus standard initiation of renal replacement therapy in furosemide stress test non-responsive acute kidney injury patients (the FST trial) JO: Crit Care http://www.kidney.de/pget.php?&tw=1&pmid=29673370 #FOAvip BACKGROUND: The timing of initiation of renal replacement therapy (RRT) in severe acute kidney injury (AKI) remains controversial, with early initiation resulting in unnecessary therapy for some patients while expectant therapy may delay RRT for other patients. The furosemide stress test (FST) has been shown to predict the need for RRT and therefore could be used to exclude low-risk patients from enrollment in trials of RRT timing. We conducted this multicenter pilot study to determine whether FST could be used to screen patients at high risk for RRT and to determine the feasibility of incorporating FST into a trial of early initiation of RRT. METHODS: FST was performed using intravenous furosemide (1 mg/kg in furosemide-naive patients or 1.5 mg/kg in previous furosemide users). FST-nonresponsive patients (urine output less than 200 mL in 2 h) were then randomized to early (initiation within 6 h) or standard (initiation by urgent indication) RRT. RESULTS: FST was completed in all patients (100%). Only 6/44 (13.6%) FST-responsive patients ultimately received RRT while 47/60 (78.3%) nonresponders randomized to standard RRT either received RRT or died (P?<? 0.001). Among 118 FST-nonresponsive patients, 98.3% in the early RRT arm and 75% in the standard RRT arm received RRT. The adherence to the protocol was 94.8% and 100% in the early and standard RRT group, respectively. We observed no differences in 28-day mortality (62.1 versus 58.3%, P?=?0.68), 7-day fluid balance, or RRT dependence at day 28. However, hypophosphatemia occurred more frequently in the early RRT arm (P?=?0.002). CONCLUSION: The furosemide stress test appears to be feasible and effective in identifying patients for randomization to different RRT initiation times. Our findings should guide implementation of large-scale randomized controlled trials for the timing of RRT initiation. TRIAL REGISTRATION: clinicaltrials.gov, NCT02730117 . Registered 6 April 2016. Twit Text FOAVip Early versus standard initiation of renal replacement therapy in furosemide stress test non-responsive acute kidney injury patients (the FST trial) ????Crit Care http://www.kidney.de/pget.php?&tw=1&pmid=29673370 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=29673370 #FOAvip English Wikipedia <ref>{{Cite pmid|29673370 }}</ref> Early versus standard initiation of renal replacement therapy in furosemide stress test non-responsive acute kidney injury patients (the FST trial) #MMPMID29673370 Lumlertgul N ; Peerapornratana S ; Trakarnvanich T ; Pongsittisak W ; Surasit K ; Chuasuwan A ; Tankee P ; Tiranathanagul K ; Praditpornsilpa K ; Tungsanga K ; Eiam-Ong S ; Kellum JA ; Srisawat N Crit Care 2018[Apr]; 22 (1 ): 101 PMID29673370 show ga BACKGROUND: The timing of initiation of renal replacement therapy (RRT) in severe acute kidney injury (AKI) remains controversial, with early initiation resulting in unnecessary therapy for some patients while expectant therapy may delay RRT for other patients. The furosemide stress test (FST) has been shown to predict the need for RRT and therefore could be used to exclude low-risk patients from enrollment in trials of RRT timing. We conducted this multicenter pilot study to determine whether FST could be used to screen patients at high risk for RRT and to determine the feasibility of incorporating FST into a trial of early initiation of RRT. METHODS: FST was performed using intravenous furosemide (1 mg/kg in furosemide-naive patients or 1.5 mg/kg in previous furosemide users). FST-nonresponsive patients (urine output less than 200 mL in 2 h) were then randomized to early (initiation within 6 h) or standard (initiation by urgent indication) RRT. RESULTS: FST was completed in all patients (100%). Only 6/44 (13.6%) FST-responsive patients ultimately received RRT while 47/60 (78.3%) nonresponders randomized to standard RRT either received RRT or died (P? |*Time Factors [MESH] |APACHE [MESH] |Acute Kidney Injury/therapy [MESH] |Aged [MESH] |Aged, 80 and over [MESH] |Analysis of Variance [MESH] |Chi-Square Distribution [MESH] |Exercise Test/*methods [MESH] |Female [MESH] |Furosemide/*pharmacology/therapeutic use [MESH] |Humans [MESH] |Male [MESH] |Middle Aged [MESH] |Organ Dysfunction Scores [MESH] |Predictive Value of Tests [MESH] |Proportional Hazards Models [MESH] |Renal Replacement Therapy/*methods [MESH] |Risk Factors [MESH] |Severity of Illness Index [MESH] |Thailand [MESH]Early versus standard initiation of renal replacement therapy in furos(epmc).pdf DeepDyve Pubget Overpricing