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Association between furosemide administration and outcomes in critically ill patients with acute kidney injury.


ABSTRACT:

Background

Although current guidelines for AKI suggested against the use of furosemide in AKI management, the effect of furosemide on outcomes in real-world clinical settings remains uncertain. The aim of the present study was to investigate the association between furosemide administration and outcomes in critically ill patients with AKI using real-world data.

Methods

Critically ill patients with AKI were identified from the Medical Information Mart for Intensive Care (MIMIC)-III database. Propensity score (PS) matched analysis was used to match patients receiving furosemide to those without diuretics treatment. Linear regression, logistic regression model, and Cox proportional hazards model were used to assess the associations between furosemide and length of stay, recovery of renal function, and in-hospital and 90-day mortality, respectively.

Results

A total of 14,154 AKI patients were included in the data analysis. After PS matching, 4427 pairs of patients were matched between the patients who received furosemide and those without diuretics treatment. Furosemide was associated with reduced in-hospital mortality [hazard ratio (HR) 0.67; 95% CI 0.61-0.74; P ConclusionsFurosemide administration was associated with improved short-term survival and recovery of renal function in critically ill patients with AKI. Furosemide was especially effective in patients with AKI UO stage 2-3 degree. However, it was not effective in those with AKI SCr stage 2-3 and chronic kidney disease. The results need to be verified in randomized controlled trials.

SUBMITTER: Zhao GJ 

PROVIDER: S-EPMC7057586 | biostudies-literature | 2020 Mar

REPOSITORIES: biostudies-literature

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Publications

Association between furosemide administration and outcomes in critically ill patients with acute kidney injury.

Zhao Guang-Ju GJ   Xu Chang C   Ying Jian-Chao JC   Lü Wen-Biao WB   Hong Guang-Liang GL   Li Meng-Fang MF   Wu Bing B   Yao Yong-Ming YM   Lu Zhong-Qiu ZQ  

Critical care (London, England) 20200304 1


<h4>Background</h4>Although current guidelines for AKI suggested against the use of furosemide in AKI management, the effect of furosemide on outcomes in real-world clinical settings remains uncertain. The aim of the present study was to investigate the association between furosemide administration and outcomes in critically ill patients with AKI using real-world data.<h4>Methods</h4>Critically ill patients with AKI were identified from the Medical Information Mart for Intensive Care (MIMIC)-III  ...[more]

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