SPARK Trial Summary: Furosemide in critically ill patients with early AKI

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2017 SPARK TRIAL The effect of low-dose furosemide in critically illl patients with early acute kidney injury (AKI) Pilot, multicenter, randomized, double-blinded, placebo-controlled trial Objective: To evaluate the impact of furosemide in early AKI on worsening AKI, kidney recovery and RRT use as compared to placebo. 73 Patients > 18 years with RISK RIFLE category AKI (Creatinine x 1.5 of baseline or UO < 0.5 ml/kg/hr for 6h); 2 SIRS criteria ;Peripheral or central catheter + urinary catheter; Immediate resuscitation goals met, fluid resuscitated or vasoactive agents commenced patients Furosemide (n=37) Placebo (n=36) PRIMARY OUTCOME 43.2 Worsening AKI % OR 1.52; 95% CI 0.61 to 3.83; P=0.48 37.1 SECONDARY OUTCOMES 29.7 Kidney recovery % P= 0.3 Kidney recovery * 42.9 27.0 RRT % P= 0.8 28.6 Adverse events, mostly electrolyte abnormalities, more common in furosemide-treated patients P<0.001 Conclusion: In this pilot trial, furosemide did not reduce the rate of worsening AKI, improve recovery or reduce RRT; however, was associated with greater electrolyte abnormalities SM Bagshaw et al. Journal of critical care 2017;42:138-146