Evidence map›Paper›PMID 38691152›Full record

ArticlePediatric nephrology (Berlin, Germany)2025

Furosemide stress test to predict acute kidney injury progression in critically ill children.

Sudarsan Krishnasamy, Aditi Sinha, Rakesh Lodha, Jhuma Sankar, Mohamad Tarik, Lakshmy Ramakrishnan, Arvind Bagga, Pankaj Hari

Abstract read
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In one paragraph

Article in Pediatric nephrology (Berlin, Germany), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
2.0field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 6 citations in OpenAlex.

  1. Review
  2. Research progress on biomarkers for acute kidney injury in children.Pediatric nephrology (Berlin, Germany) · 2026
    Review
  3. Kidney Support Therapy: Recent Advances.Indian journal of pediatrics · 2026
    Review
  4. Observational
  5. Article
  6. Article
4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

8 authors at 3 institutions in 1 country.

Sudarsan KrishnasamyPediatric Nephrology Services, Department of Paediatrics, Jawaharlal Institute of Post Graduate Medical Education and Research (JIPMER), Pondicherry, India.
Aditi SinhaDivision of Nephrology, Department of Pediatrics, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
Rakesh LodhaDivision of Pediatric Pulmonology and Intensive Care, Department of Pediatrics, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
Jhuma SankarDivision of Pediatric Pulmonology and Intensive Care, Department of Pediatrics, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
Mohamad TarikDepartment of Cardiac Biochemistry, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
Lakshmy RamakrishnanDepartment of Cardiac Biochemistry, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
Arvind BaggaDirector Paediatrics and Senior Consultant Pediatric Nephrology, Indraprastha Apollo Hospitals, New Delhi, India.
Pankaj HariDivision of Nephrology, Department of Pediatrics, All India Institute of Medical Sciences (AIIMS), New Delhi, India. pankajhari@hotmail.com.
All India Institute of Medical Sciences · INApollo Hospitals · INJawaharlal Institute of Post Graduate Medical Education and Research · IN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFurosemide stress test (FST) is a novel functional biomarker for predicting severe acute kidney injury (AKI); however, pediatric studies are limited.

methodsChildren 3 months to 18 years of age admitted to the intensive care unit (ICU) of a tertiary care hospital from Nov 2019 to July 2021 were screened and those who developed AKI stage 1 or 2 within 7 days of admission underwent FST (intravenous furosemide 1 mg/kg). Urine output was measured hourly for the next 6 h; a value > 2 ml/kg within the first 2 h was deemed furosemide responsive. Other biomarkers like plasma neutrophil gelatinase-associated lipocalin (NGAL) and proenkephalin (PENK) were also evaluated.

resultsOf the 480 admitted patients, 51 developed AKI stage 1 or 2 within 7 days of admission and underwent FST. Nine of these patients were furosemide non-responsive. Thirteen (25.5%) patients (eight of nine from FST non-responsive group) developed stage 3 AKI within 7 days of FST, nine (17.6%) of whom (seven from non-responsive group) required kidney support therapy (KST). FST emerged as a good biomarker for predicting stage 3 AKI and need for KST with area-under-the-curve (AUC) being 0.93 ± 0.05 (95% CI 0.84-1.0) and 0.96 ± 0.03 (95% CI 0.9-1.0), respectively. FST outperformed NGAL and PENK in predicting AKI stage 3 and KST; however, the combination did not improve the diagnostic accuracy.

conclusionsFurosemide stress test is a simple, inexpensive, and robust biomarker for predicting stage 3 AKI and KST need in critically ill children. Further research is required to identify the best FST cut-off in children.

Indexed as

Acute Kidney InjuryBiomarkersCritical IllnessFurosemideLipocalin-2AdolescentChildChild, PreschoolDisease ProgressionDiureticsEnkephalinsFemaleHumansInfantMalePredictive Value of TestsBiomarkersDiureticsEnkephalinsFurosemideLCN2 protein, humanLipocalin-2proenkephalinProtein PrecursorsAcute kidney injuryBiomarkerFSTFurosemide stress testNGALPENK

Identifiers

PMID38691152
OpenAlexW4396553571

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.