Low Dose Continuous Furosemide Effect on Cardiac Surgery Patients With Kidney Dysfunction
Status:
Recruiting
Trial end date:
2022-02-28
Target enrollment:
Participant gender:
Summary
Chronic kidney disease is an independent risk factor for cardiovascular disease associated
with increased mortality rate during cardiac surgery in proportion to the kidney function.
Chronic kidney disease is defined by decreased glomerular filtration rate (GFR) as classified
by Kidney Disease: Improving Global Outcome (KDIGO). Deterioration of kidney function has a
complex and multifactorial pathophysiologic derangement. In order to counter kidney injury
associated with cardiac surgery, several pharmacologic and non-pharmacologic interventions
have been studied to prevent perioperative deterioration of kidney function. Diuretics as
pharmacologic measure are often used post-cardiac surgery to treat fluid overload and
managing patient with acute kidney injury by preventing anuria. Loop diuretics (furosemide)
may improve renal blood flow, decrease reabsorption in renal tubules, decrease oxygen demand
and energy consumption (blocking potassium/sodium/2cloride co-transport in loop of Henle),
and prevent hypoxic injury of renal medulla. Low dose continuous furosemide hypothetically
has a protective effect on cardiac surgery patients with kidney dysfunction, measured
improved glomerular filtration rate, decreased indication for therapeutic furosemide
infusion, and decreased need of renal replacement therapy. On the other hand, administration
of furosemide is rather harmful in severe kidney dysfunction. Therefore, the objective of
this study is to determine the protective effect of low-dose continuous furosemide
perioperative in cardiac surgery patients with mild to moderate kidney dysfunction.
Phase:
Phase 2
Details
Lead Sponsor:
National Cardiovascular Center Harapan Kita Hospital Indonesia