Acute Kidney Injury, Heart Failure
Conditions
Brief summary
This study is aim to study the changes of serum creatinine levels at 72 hours after admission in patients with acute heart failure who has diuretic resistance compared to those who do not have diuretic resistance from furosemide stress test
Detailed description
This study is an observational prospective study to demonstrate a prognosis of acute heart failure patients who have diuretic resistance compared to those who do not have diuretic resistance from furosemide stress test. The primary outcome is changes of serum creatinine levels at 72 hours compared to baseline values at the time of admission.
Interventions
DIAGNOSTIC_TESTFurosemide stress test
Furosemide stress test is performed by administration of intravenous furosemide 1 mg/kg in patients who do not receive oral furosemide before and 1.5 mg/kg patients who have never received oral furosemide.
Sponsors
Chiang Mai University
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age ≥18 years * Diagnosis of acute heart failure which is defined by 2 of the 3 following features: ≥2+ leg edema, jugular venous pressure \>10 cm from physical examination or central venous pressure \>10 mmHg, and bilateral pulmonary edema or bilateral pleural effusion from chest radiography * Patients consent to participate into the study
Exclusion criteria
* Patients who receive furosemide ≥500 mg/day or hydrochlorothiazide ≥100 mg/day or spironolactone ≥100 mg/day or tolvaptan of any doses * Patients who have systolic blood pressure \<100 mmHg or who need vasoactive drugs inotropic agents (except dobutamine) * Patients with intravascular volume depletion from clinical evaluation * Patients with chronic kidney disease stage 5 (estimated glomerular filtration rate \<15 ml/min/1.73 m2) or patients who receive maintenance dialysis * Patients who require renal replacement therapy at the time of admission * Patients whom diagnosed hypertrophic obstructive cardiomyopathy, severe valvular stenosis or complex congenital heart disease * Patients with sepsis or systemic infection * Pregnant women * Patients who have history of furosemide, spironolactone or hydrochlorothiazide allergy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Serum creatinine | Seventy-two hours after admission | Changes in serum creatinine from baseline |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Requirement for renal replacement therapy | During hospital admission period | Renal replacement therapy is defined as any mode of dialysis or extracorporeal therapy to treat volume overload for heart failure |
| Length of hospital admission | During hospital admission period | Numbers of days that patients need to stay in the hospital |
| Serum creatinine | Day 7 of hospital admission | Changes in serum creatinine from baseline |
| Numbers of hospital readmission | Month 1 and 3 after hospital discharge | Readmission to the hospital due to heart failure |
| Mortality rate | Day 7 and 28 after hospital admission | Confirmed death |
| Changes of the stage of heart failure defined by New York Heart Association (NYHA) classification | Day 7 and 28 after hospital admission | Heart failure stage defined by New York Heart Association (NYHA) classification |
Countries
Thailand
Contacts
Primary ContactKajohnsak Noppakun, MD
Backup ContactTiranun Suriya, RN
Outcome results
None listed