Hamishehkar Hadi, Sanaie Sarvin, Fattahi Vahid, Mesgari Mehran, Mahmoodpoor Ata
Department of Clinical Pharmacy, Applied Drug Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Tuberculosis and Lung Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Indian J Crit Care Med. 2017 Jul;21(7):442-447. doi: 10.4103/ijccm.IJCCM_93_17.
Oliguric acute kidney injury (AKI), commonly attributed to a more severe degree of renal injury, is associated with poorer prognosis than nonoliguric form. The aim of this study was to determine the effect of furosemide therapy on kidney function and on the level of neutrophil gelatinase-associated lipocalin (NGAL) in critically hospitalized patients in the Intensive Care Unit (ICU).
In this randomized controlled trial, 106 ICU patients with AKI were assigned into furosemide and control groups. In furosemide group, 40-80 mg of intravenous furosemide was administrated, followed by 1-5 mg/h furosemide infusion. In control group, patients received standard treatment. Serum and urinary NGAL were measured on the 1, 3, and 7 days of the study.
The results of this study indicated that during the study, serum blood urea nitrogen levels of patients increased in both groups; this, however, was significant only in the control group ( = 0.009). Both plasma and urine NGAL decreased significantly ( < 0.05) in both groups. The findings of 28-day mortality follow-up revealed that 20% and 28% of patients died in the furosemide and the control groups, respectively.
NGAL was not found to reflect any positive or negative effects of Furosemide in patients with AKI.
少尿型急性肾损伤（AKI）通常归因于更严重程度的肾损伤，与非少尿型相比，其预后较差。本研究的目的是确定速尿治疗对重症监护病房（ICU）中重症住院患者肾功能及中性粒细胞明胶酶相关脂质运载蛋白（NGAL）水平的影响。
在这项随机对照试验中，106例患有AKI的ICU患者被分为速尿组和对照组。速尿组静脉注射40 - 80mg速尿，随后以1 - 5mg/h的速度输注速尿。对照组患者接受标准治疗。在研究的第1、3和7天测量血清和尿液中的NGAL。
本研究结果表明，在研究期间，两组患者的血清血尿素氮水平均升高；然而，仅在对照组中显著升高（P = 0.009）。两组患者的血浆和尿液NGAL均显著下降（P < 0.05）。28天死亡率随访结果显示，速尿组和对照组分别有20%和28%的患者死亡。
未发现NGAL能反映速尿对AKI患者的任何正面或负面影响。
