Abstract
GFR measurement or estimation is a cornerstone in the diagnosis and staging of acute kidney injury (AKI) and CKD. RFR is the difference between peak “stress” GFR induced by the test (p.o. or i.v.) and the baseline GFR. With each AKI episode some nephrons are lost. So while the serum creatinine may return to baseline a part of the renal reserve would be lost. “Renal stress testing” provides clinically relevant insights into kidney function and prognosis.
Urine output is an important characteristic related to the severity and even duration of AKI. However, oliguria is a late marker of AKI in critically sick patients. The Furosemide stress test involves evaluating the furosemide responsiveness, by means of diuretic-induced increase in urine output, and assesses the integrity of renal tubular function in the setting of early AKI. This may help predict progression of AKI to more severe stages and anticipate the need of RRT, decisions on its appropriate timing.
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Mittal, A., Sethi, S.K. (2021). Functional Renal Reserve and Furosemide Stress Test. In: Sethi, S.K., Raina, R., McCulloch, M., Bunchman, T.E. (eds) Advances in Critical Care Pediatric Nephrology. Springer, Singapore. https://doi.org/10.1007/978-981-33-4554-6_18
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