{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T08:12:33Z","timestamp":1791360753278,"version":"4.3.1"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,8]]},"abstract":"\n \n \n Clinicians have access to limited tools that predict which patients with early AKI will progress to more severe stages. In early AKI, urine output after a furosemide stress test (FST), which involves intravenous administration of furosemide (1.0 or 1.5 mg\/kg), can predict the development of stage 3 AKI. We measured several AKI biomarkers in our previously published cohort of 77 patients with early AKI who received an FST and evaluated the ability of FST urine output and biomarkers to predict the development of stage 3 AKI (\n n<\/jats:italic>\n =25 [32.5%]), receipt of RRT (\n n<\/jats:italic>\n =11 [14.2%]), or inpatient mortality (\n n<\/jats:italic>\n =16 [20.7%]). With an area under the curve (AUC)\u00b1SEM of 0.87\u00b10.09 (\n P<\/jats:italic>\n <0.0001), 2-hour urine output after FST was significantly better than each urinary biomarker tested in predicting progression to stage 3 (\n P<\/jats:italic>\n <0.05). FST urine output was the only biomarker to significantly predict RRT (0.86\u00b10.08;\n P<\/jats:italic>\n =0.001). Regardless of the end point, combining FST urine output with individual biomarkers using logistic regression did not significantly improve risk stratification (\n \u0394<\/jats:italic>\n AUC,\n P<\/jats:italic>\n >0.10 for all). When FST urine output was assessed in patients with increased biomarker levels, the AUC for progression to stage 3 improved to 0.90\u00b10.06 and the AUC for receipt of RRT improved to 0.91\u00b10.08. Overall, in the setting of early AKI, FST urine output outperformed biochemical biomarkers for prediction of progressive AKI, need for RRT, and inpatient mortality. Using a FST in patients with increased biomarker levels improves risk stratification, although further research is needed.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1681\/asn.2014060535","type":"journal-article","created":{"date-parts":[[2015,2,5]],"date-time":"2015-02-05T23:05:38Z","timestamp":1423177538000},"page":"2023-2031","source":"Crossref","is-referenced-by-count":246,"title":["Furosemide Stress Test and Biomarkers for the Prediction of AKI Severity"],"prefix":"10.1681","volume":"26","author":[{"given":"Jay L.","family":"Koyner","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle L.","family":"Davison","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ermira","family":"Brasha-Mitchell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Divya M.","family":"Chalikonda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John M.","family":"Arthur","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew D.","family":"Shaw","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James A.","family":"Tumlin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon A.","family":"Trevino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael R.","family":"Bennett","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul L.","family":"Kimmel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael G.","family":"Seneff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lakhmir S.","family":"Chawla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-27-20240223","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1016\/S0002-9343(98)00058-8","article-title":"Independent association between acute renal failure and mortality following cardiac surgery.","volume":"104","author":"Chertow","year":"1998","journal-title":"Am J Med"},{"key":"R2-27-20240223","doi-asserted-by":"crossref","first-page":"1801","DOI":"10.1001\/jama.297.16.1801","article-title":"Derivation and validation of a simplified predictive index for renal replacement therapy after cardiac surgery.","volume":"297","author":"Wijeysundera","year":"2007","journal-title":"JAMA"},{"key":"R3-27-20240223","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1053\/j.ajkd.2014.03.018","article-title":"The daily burden of acute kidney injury: A survey of US nephrologists on World Kidney Day.","volume":"64","author":"Koyner","year":"2014","journal-title":"Am J Kidney Dis"},{"key":"R4-27-20240223","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1681\/ASN.2012080800","article-title":"Temporal changes in incidence of dialysis-requiring AKI.","volume":"24","author":"Hsu","year":"2013","journal-title":"J Am Soc Nephrol"},{"key":"R5-27-20240223","doi-asserted-by":"crossref","first-page":"861","DOI":"10.2215\/CJN.12191111","article-title":"Ongoing clinical trials in AKI.","volume":"7","author":"Faubel","year":"2012","journal-title":"Clin J Am Soc Nephrol"},{"key":"R6-27-20240223","doi-asserted-by":"crossref","first-page":"1034","DOI":"10.2215\/CJN.05150512","article-title":"Clinical utility of biomarkers of AKI in cardiac surgery and critical illness.","volume":"8","author":"Koyner","year":"2013","journal-title":"Clin J Am Soc Nephrol"},{"key":"R7-27-20240223","doi-asserted-by":"crossref","first-page":"1301","DOI":"10.1093\/ndt\/gft510","article-title":"A basic science view of acute kidney injury biomarkers.","volume":"29","author":"Charlton","year":"2014","journal-title":"Nephrol Dial Transplant"},{"key":"R8-27-20240223","doi-asserted-by":"crossref","first-page":"2154","DOI":"10.2215\/CJN.00740110","article-title":"Urinary biomarkers in the clinical prognosis and early detection of acute kidney injury.","volume":"5","author":"Koyner","year":"2010","journal-title":"Clin J Am Soc Nephrol"},{"key":"R9-27-20240223","doi-asserted-by":"crossref","first-page":"905","DOI":"10.1681\/ASN.2011090907","article-title":"Biomarkers predict progression of acute kidney injury after cardiac surgery.","volume":"23","author":"Koyner","year":"2012","journal-title":"J Am Soc Nephrol"},{"key":"R10-27-20240223","doi-asserted-by":"crossref","first-page":"R25","DOI":"10.1186\/cc12503","article-title":"Discovery and validation of cell cycle arrest biomarkers in human acute kidney injury.","volume":"17","author":"Kashani","year":"2013","journal-title":"Crit Care"},{"key":"R12-27-20240223","doi-asserted-by":"crossref","first-page":"932","DOI":"10.1164\/rccm.201401-0077OC","article-title":"Validation of cell-cycle arrest biomarkers for acute kidney injury using clinical adjudication.","volume":"189","author":"Bihorac","year":"2014","journal-title":"Am J Respir Crit Care Med"},{"key":"R13-27-20240223","doi-asserted-by":"crossref","first-page":"R207","DOI":"10.1186\/cc13015","article-title":"Development and standardization of a furosemide stress test to predict the severity of acute kidney injury.","volume":"17","author":"Chawla","year":"2013","journal-title":"Crit Care"},{"key":"R15-27-20240223","doi-asserted-by":"crossref","first-page":"644","DOI":"10.1038\/ki.2013.168","article-title":"Biomarkers and creatinine in AKI: The trough of disillusionment or the slope of enlightenment?","volume":"84","author":"Endre","year":"2013","journal-title":"Kidney Int"},{"key":"R16-27-20240223","doi-asserted-by":"crossref","first-page":"1023","DOI":"10.1053\/j.ajkd.2013.09.002","article-title":"Variation in performance of kidney injury biomarkers due to cause of acute kidney injury.","volume":"62","author":"Parikh","year":"2013","journal-title":"Am J Kidney Dis"},{"key":"R17-27-20240223","doi-asserted-by":"crossref","first-page":"1748","DOI":"10.1681\/ASN.2010121302","article-title":"Postoperative biomarkers predict acute kidney injury and poor outcomes after adult cardiac surgery.","volume":"22","author":"Parikh","year":"2011","journal-title":"J Am Soc Nephrol"},{"key":"R19-27-20240223","doi-asserted-by":"crossref","first-page":"844","DOI":"10.2215\/CJN.12791211","article-title":"Design of clinical trials in acute kidney injury: Report from an NIDDK workshop on trial methodology.","volume":"7","author":"Palevsky","year":"2012","journal-title":"Clin J Am Soc Nephrol"},{"key":"R20-27-20240223","doi-asserted-by":"crossref","first-page":"851","DOI":"10.2215\/CJN.12811211","article-title":"Design of clinical trials in acute kidney injury: Areport from an NIDDK workshop\u2014prevention trials.","volume":"7","author":"Okusa","year":"2012","journal-title":"Clin J Am Soc Nephrol"},{"key":"R21-27-20240223","doi-asserted-by":"crossref","first-page":"856","DOI":"10.2215\/CJN.12821211","article-title":"Design of clinical trials in AKI: A report from an NIDDK workshop. Trials of patients with sepsis and in selected hospital settings.","volume":"7","author":"Molitoris","year":"2012","journal-title":"Clin J Am Soc Nephrol"},{"key":"R22-27-20240223","doi-asserted-by":"crossref","first-page":"1606","DOI":"10.2215\/CJN.06040613","article-title":"AKI: A path forward.","volume":"8","author":"Bonventre","year":"2013","journal-title":"Clin J Am Soc Nephrol"},{"key":"R23-27-20240223","doi-asserted-by":"crossref","first-page":"2043","DOI":"10.2215\/CJN.03510413","article-title":"Association of elevated urinary concentration of renin-angiotensin system components and severe AKI.","volume":"8","author":"Alge","year":"2013","journal-title":"Clin J Am Soc Nephrol"},{"key":"R24-27-20240223","doi-asserted-by":"crossref","first-page":"184","DOI":"10.2215\/CJN.06280612","article-title":"Urinary angiotensinogen and risk of severe AKI.","volume":"8","author":"Alge","year":"2013","journal-title":"Clin J Am Soc Nephrol"},{"key":"R25-27-20240223","doi-asserted-by":"crossref","first-page":"R31","DOI":"10.1186\/cc5713","article-title":"Acute Kidney Injury Network: Report of an initiative to improve outcomes in acute kidney injury.","volume":"11","author":"Mehta","year":"2007","journal-title":"Crit Care"},{"key":"R26-27-20240223","doi-asserted-by":"crossref","first-page":"c145","DOI":"10.1159\/000166605","article-title":"Urinary sediment cast scoring index for acute kidney injury: A pilot study.","volume":"110","author":"Chawla","year":"2008","journal-title":"Nephron Clin Pract"},{"key":"R27-27-20240223","doi-asserted-by":"crossref","first-page":"1737","DOI":"10.1681\/ASN.2010111163","article-title":"Postoperative biomarkers predict acute kidney injury and poor outcomes after pediatric cardiac surgery.","volume":"22","author":"Parikh","year":"2011","journal-title":"J Am Soc Nephrol"},{"key":"R28-27-20240223","doi-asserted-by":"crossref","first-page":"128","DOI":"10.7150\/ijbs.5.128","article-title":"Assay validation for KIM-1: Human urinary renal dysfunction biomarker.","volume":"5","author":"Chaturvedi","year":"2009","journal-title":"Int J Biol Sci"},{"key":"R30-27-20240223","doi-asserted-by":"crossref","first-page":"837","DOI":"10.2307\/2531595","article-title":"Comparing the areas under two or more correlated receiver operating characteristic curves: A nonparametric approach.","volume":"44","author":"DeLong","year":"1988","journal-title":"Biometrics"},{"key":"R31-27-20240223","doi-asserted-by":"crossref","first-page":"907","DOI":"10.1164\/rccm.200908-1214OC","article-title":"Neutrophil gelatinase-associated lipocalin at ICU admission predicts for acute kidney injury in adult patients.","volume":"183","author":"de Geus","year":"2011","journal-title":"Am J Respir Crit Care Med"}],"container-title":["Journal of the American Society of Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/00001751-201508000-00027","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T19:27:21Z","timestamp":1786130841000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/00001751-201508000-00027"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,8]]},"references-count":27,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2015]]}},"URL":"https:\/\/doi.org\/10.1681\/asn.2014060535","relation":{"has-review":[{"id-type":"doi","id":"10.3410\/f.725347402.793509694","asserted-by":"object"}]},"ISSN":["1046-6673"],"issn-type":[{"value":"1046-6673","type":"print"}],"subject":[],"published":{"date-parts":[[2015,8]]}}}