Kidney Week

Abstract: SA-PO842

Association Between Urine Output, Furosemide Stress Test, and Fibrosis in Kidney Biopsies

Session Information

• Molecular Mechanisms of CKD - III
  October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 1903 CKD (Non-Dialysis): Mechanisms

Authors

• Martinez, Jesus Arturo Rivero, Instituto Nacional de Cardiologia Ignacio Chavez, Tlalpan, DIStrito federal, Mexico

Jesus Arturo Rivero Martinez,

• Chawla, Lakhmir S., University of California, San Diego, San Diego, California, United States

Lakhmir S. Chawla,

• Mehta, Ravindra L., University of California, San Diego, San Diego, California, United States

Ravindra L. Mehta,

• Vaingankar, Sucheta M., University of California, San Diego, San Diego, California, United States

Sucheta M. Vaingankar,

• Rodríguez, Francisco, Instituto Nacional de Cardiologia Ignacio Chavez, Tlalpan, DIStrito federal, Mexico

Francisco Rodríguez,

• Soto, Virgilia, Instituto Nacional de Cardiologia Ignacio Chavez, Tlalpan, DIStrito federal, Mexico

Virgilia Soto,

• Camacho briseño, María Fernanda, UNAM, Ciudad de México, Mexico

María Fernanda Camacho briseño,

• Duarte, Ricardo, Public, MEXICO CITY, Mexico

Ricardo Duarte,

• Cabrera-Jara, Alejandro, UNAM, Ciudad de México, Mexico

Alejandro Cabrera-Jara,

• Garza-Garcia, Carlos Alberto, Private Practice , Monterrey, DIStrito federal, Mexico

Carlos Alberto Garza-Garcia,

• Madero, Magdalena, Instituto Nacional de Cardiologia Ignacio Chavez, Tlalpan, DIStrito federal, Mexico

Magdalena Madero,

Background

Interstitial fibrosis (IF) is one of the most potent risk factors for kidney disease progression. The Furosemide Stress Test (FST) is a validated tool that predicts the severity of acute kidney injury in critically ill patients. To our knowledge there is no data on the association between the functional tubular capacity by urine output (UO) and FST with IF on kidney biopsies. The aim of this study was to determine the correlation between UO, FST and the severity of IF in kidney biopsies

Methods

84 patients that underwent kidney biopsy were included. Furosemde was administred at 1 mg/kg and UO was measured every h for 6 after confirmation of empty bladder by US. Serum biochemical markers were measured and urine concentrations of furosemide at different times (2, 4 and 6 hours). IF was evaluated by subjective visualization by an experienced nephropathologist in addition to morphometry. We used the FEM equation to determine the Mass of Excretion of Furosemide (FEM: Furosemide Urine x Volume urinary)/furosemide administered dose). Values were expressed as mean, SD or % and Pearson Correlation

Results

Nephrotic syndrome and acute kidney graft dysfunction were the most frequent indications for biopsy. eGFR was inversely proportional to the degree of fibrosis. Subjects with grade 3 IF showed a significant decrease in urine volume at hour 1 when compared with grades I and II (155 mL ± 181 vs 316 mL ± 261 vs 328 mL ± 352 p=0.015 respectively). Likewise, the total urine volume and the excreted mass of Furosemide was progressively lower with higher degrees of IF, at 2 and 4 hours. An inversely proportional linear correlation between uresis and the degree of IF (R²0.072) was observed

Conclusion

Our findings support that IF correlates with total UO and FEM. Both urine output and FST acould be a non invasive tool to predict IF.

Funding

• Veterans Affairs Support