Modified furosemide responsiveness index and biomarkers for AKI progression and prognosis: a prospective observational study
Authors' conclusion
As a rapid, cost-effective and easily accessible biomarker, mFRI, exhibited superior or comparable predictive capabilities for AKI progression and prognosis compared to renal biomarkers in cardiac surgical patients with mild to moderate AKI.
Study context
- Population
- Patients with initial mild and moderate AKI (KDIGO stage 1 to 2) within 48 h after cardiac surgery
- Participants
- 1,013 patients
- Exposure
- Modified furosemide responsiveness index (mFRI) vs Renal biomarkers and cytokines
- Outcome
- AKI progression
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
| Group | AUC | 95% CI |
|---|---|---|
| mFRI | 0.80 | 0.77-0.82 |
mFRI
AUC0.80
95% CI0.77-0.82
- AKI progression occurred
- 154 (15.2%)
Observational data: associations, not effects.
Further findings
| Outcome | mFRI |
|---|---|
| Progression to stage 3 | |
| AUC | 0.87 |
| 95% CI | 0.85-0.89 |
| Composite of hospital mortality or RRT | |
| AUC | 0.85 |
| 95% CI | 0.82-0.87 |
- Progression to stage 3 — Progressed to stage 3
- 59 (5.8%)
- Composite of hospital mortality or RRT — Met composite outcome
- 33 (3.3%)
mFRI combined with uNAG or uNGAL
- Significantly improved prediction of adverse renal outcomes vs either biomarker alone
- all P < 0.05
- Panels added to clinical model significantly enhanced prediction (C index, integrated discrimination improvement, net reclassification improvement)
- all P < 0.05
Original publication
Modified furosemide responsiveness index and biomarkers for AKI progression and prognosis: a prospective observational study. Ann Intensive Care. Published 8 October 2024. doi:10.
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