Role of the Furosemide Stress Test in Renal Injury Prognosis

Int J Mol Sci. 2020 Apr 27;21(9):3086. doi: 10.3390/ijms21093086.

Abstract

Risk stratification and accurate patient prognosis are pending issues in the management of patients with kidney disease. The furosemide stress test (FST) has been proposed as a low-cost, fast, safe, and easy-to-perform test to assess tubular integrity, especially when compared to novel plasma and urinary biomarkers. However, the findings regarding its clinical use published so far provide insufficient evidence to recommend the generalized application of the test in daily clinical routine. Dosage, timing, and clinical outcomes of the FST proposed thus far have been significantly different, which further accentuates the need for standardization in the application of the test in order to facilitate the comparison of results between series. This review will summarize published research regarding the usefulness of the FST in different settings, providing the reader some insights about the possible implications of FST in clinical decision-making in patients with kidney disease and the challenges that research will have to address in the near future before widely applying the FST.

Keywords: acute kidney injury; functional assessment; furosemide stress test; renal biomarkers.

Publication types

  • Review

MeSH terms

  • Acute Kidney Injury / diagnosis*
  • Acute Kidney Injury / etiology
  • Acute Kidney Injury / therapy
  • Acute Kidney Injury / urine*
  • Biomarkers*
  • Clinical Decision-Making
  • Disease Management
  • Furosemide / adverse effects
  • Furosemide / pharmacokinetics*
  • Furosemide / therapeutic use
  • Humans
  • Kidney Function Tests / methods*
  • Kidney Transplantation
  • Prognosis
  • Sodium Potassium Chloride Symporter Inhibitors / adverse effects
  • Sodium Potassium Chloride Symporter Inhibitors / pharmacokinetics*
  • Sodium Potassium Chloride Symporter Inhibitors / therapeutic use
  • Stress, Physiological

Substances

  • Biomarkers
  • Sodium Potassium Chloride Symporter Inhibitors
  • Furosemide