The Effect of Furosemide on the Level of Neutrophil Gelatinase-associated Lipocalin in Critically Hospitalized Patients with Acute Kidney Injury

Hadi Hamishehkar; Sarvin Sanaie; Vahid Fattahi; Mehran Mesgari; Ata Mahmoodpoor

doi:10.4103/ijccm.IJCCM_93_17

The Effect of Furosemide on the Level of Neutrophil Gelatinase-associated Lipocalin in Critically Hospitalized Patients with Acute Kidney Injury

Indian J Crit Care Med. 2017 Jul;21(7):442-447. doi: 10.4103/ijccm.IJCCM_93_17.

Authors

Hadi Hamishehkar¹, Sarvin Sanaie², Vahid Fattahi³, Mehran Mesgari⁴, Ata Mahmoodpoor³

Affiliations

¹ Department of Clinical Pharmacy, Applied Drug Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
² Tuberculosis and Lung Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
³ Department of Anesthesiology and Intensive Care Medicine, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
⁴ Drug Applied Therapeutic Research Center, Radio Immunoassay Lab, Tabriz University of Medical Sciences, Tabriz, Iran.

Abstract

Background and aims: 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).

Materials and methods: 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^st, 3^rd, and 7^th days of the study.

Results: 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 (P = 0.009). Both plasma and urine NGAL decreased significantly (P < 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.

Conclusions: NGAL was not found to reflect any positive or negative effects of Furosemide in patients with AKI.

Keywords: Acute kidney injury; Intensive Care Unit; furosemide; plasma neutrophil gelatinase-associated lipocalin; urine neutrophil gelatinase-associated lipocalin.