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NCT Number: NCT06229990

Effect of a Furosemide Stress Test-Guided Strategy on Liberation From Continuous Renal Replacement Therapy in Critically Ill Patients With Acute Kidney Injury

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.

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Key information

Conditions

Acute Kidney Injury Female Urogenital Diseases Female Urogenital Diseases and Pregnancy Complications Kidney Diseases Male Urogenital Diseases Renal Insufficiency Urogenital Diseases Urologic Diseases

Age range

20 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 4

Primary location

Chiang Mai University

Chiang Mai, 50200, Thailand

Location status: Recruiting

Location contact

Prit Kusirisin, MD

CONTACT

[email protected]

+66897574028

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

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

Treatment and study plan

Furosemide Injection

Drug

After taking furosemide at 1.5 mg/kg intravenously, if the urine output exceeds 200 mL within 2 hours, the patients are going to withhold CRRT. But if there is no response, the titration of furosemide to 2.5 mg/kg and 3.5 mg/kg every 6 hours is scheduled according to the urine output >200 mL in 2 hours (not exceeding 250 mg).

Other names: Furosemide stress test

Primary outcomes

  1. % of patients with Renal recovery

    Time frame: 5 days

    Free of RRT for at least 5 days

Secondary outcomes

  1. % of patients with Mortality

    Time frame: 28 days

    28 days all cause mortality and in-hospital mortality

  2. RRT free days

    Time frame: 28 days

    No need to restart RRT

  3. Day of Hospitalization

    Time frame: 28 days

    Length of hospital stay and ICU stay

  4. Ventilator-free day

    Time frame: 28 days

    Number of mechanical ventilator-free day

  5. % of complication

    Time frame: 28 days

    CRBSI, electrolyte imbalance, urine output

  6. Cost of RRT during hospitalization

    Time frame: 28 days

    The cost of RRT since the initiation until the end of RRT during hospitalization in US dollar and Thai Baht unit

Study contacts

Contact information is provided by the study sponsor or research team.

Prit Kusirisin, MD

CONTACT

[email protected]

+66897574028

Sponsors and collaborators

Lead sponsor

Chiang Mai University

Other

Registry information

Official study title

Effect of a Furosemide Stress Test-Guided Strategy on Liberation From Continuous Renal Replacement Therapy in Critically Ill Patients With Acute Kidney Injury (FST-LIBERATE)

Acronym: FST-LIBERATE

Important dates

Study start
2024
Primary completion
2028
Study completion
2028
First posted
Jan 29, 2024
Registry last updated
Jul 16, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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