Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/16747
Title: The effect of low-dose furosemide in critically ill patients with early acute kidney injury: a pilot randomized blinded controlled trial (the SPARK study)
Austin Authors: Bagshaw, Sean M;Gibney, RT Noel;Kruger, Peter;Hassan, Imran;McAlister, Finlay A;Bellomo, Rinaldo 
Affiliation: Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Clinical Science Building, Edmonton, Alberta, Canada
Department of Intensive Care Medicine, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
School of Medicine, University of Queensland, Queensland, Australia
Epidemiology Coordinating and Research Centre (EPICORE), Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
Division of General Internal Medicine, Faculty of Medicine and Dentistry, University of Alberta, Clinical Science Building, Edmonton, Alberta, Canada
Department of Intensive Care, Austin Health, Heidelberg, Victoria, Australia
Issue Date: Dec-2017
metadata.dc.date: 2017-07-12
Publication information: Journal of Critical Care 2017; 42: 138-146
Abstract: PURPOSE: Furosemide is commonly prescribed in acute kidney injury (AKI). Prior studies have found conflicting findings on whether furosemide modifies the course and outcome of AKI. METHODS: Pilot multi-center randomized blinded placebo-controlled trial in adult patients with AKI admitted to three intensive care units. Participants were randomly allocated to furosemide bolus and infusion or 0.9% saline placebo. Primary endpoint was worsening AKI, defined by the RIFLE criteria. Secondary endpoints were kidney recovery, renal replacement therapy (RRT) and adverse events. RESULTS: The trial was terminated after enrollment of 73 participants (37 to furosemide and 36 to placebo). Mean (SD) age was 61.7 (14.3), 79.5% were medical admissions, mean (SD) APACHE II score was 26.6 (7.8), 90.4% received mechanical ventilation and 61.6% received vasoactives. Groups were similar at baseline. No differences were found in the proportion with worsening AKI (43.2% vs. 37.1%, p=0.6), kidney recovery (29.7% vs. 42.9%, p=0.3), or RRT (27.0% s. 28.6%, p=0.8). Adverse events, mostly electrolyte abnormalities, were more common in furosemide-treated patients (p<0.001). Protocol deviations were common, due often to supplementary furosemide. CONCLUSIONS: In this pilot trial, furosemide did not reduce the rate of worsening AKI, improve recovery or reduce RRT; however, was associated with greater electrolyte abnormalities. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT00978354 registered September 9, 2014.
URI: http://ahro.austin.org.au/austinjspui/handle/1/16747
DOI: 10.1016/j.jcrc.2017.07.030
ORCID: 0000-0002-1650-8939
PubMed URL: https://pubmed.ncbi.nlm.nih.gov/28732314
Type: Journal Article
Subjects: Acute kidney injury
Furosemide
Mortality
Placebo
Randomized
Recovery
Renal replacement therapy
Urine output
Appears in Collections:Journal articles

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