ASN's Mission

ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: PO0227

The Effect in Renal Function and Vascular Decongestion in Type 1 Cardiorenal Syndrome Treated with Two Strategies of Diuretics: A Randomized Trial

Session Information

Category: Acute Kidney Injury

  • 102 AKI: Clinical, Outcomes, and Trials

Authors

  • Chavez, Jonathan, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
  • Gongora, Natashia Lavelle, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
  • Arizaga Napoles, Manuel, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
  • Garcia-Garcia, Guillermo, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
  • Medina, Ramon, Hospital Civil de Guadalajara, Guadalajara, Jalisco, Mexico
  • Navarro Blackaller, Guillermo, Hospital Civil de Guadalajara, Guadalajara, Jalisco, Mexico
  • Gómez Fregoso, Juan, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
Background

In cardiorenal syndrome 1 (CRS1), is probable that sequential blockage of the renal tubule with combined diuretics (CD) will obtain similar benefits compared with stepped-dose furosemide (SF)

Methods

In a double-blind randomized controlled trial of CRS1 patients were allocated 1:1 to SF or CD. The SF group received a continuous infusion of furosemide 100mg during the first day, with daily incremental doses to 200 mg, 300 mg and 400 mg. The CD group received a combination of diuretics, including 4 consecutive days of oral chlorthalidone 50 mg, spironolactone 50 mg and infusion of furosemide 100 mg. The objectives were to assess renal function recovery and vascular decongestion.

Results

From July 2017 to February 2020, 80 patients were randomized, 40 to SF and 40 to CD group. Groups were similar at baseline and had several very high-risk features. Their mean age 59 ± 14.5 years; 37 were men (46.2%). Primary endpoint occurred in 20% of the SF group and 15.2% of the DC group (p = 0.49). All secondary and exploratory endpoints were similar between groups. Adverse events occurred frequently (85%) with no differences between groups (p = 0.53).

Conclusion

In patients with SCR-1 and a high risk of resistance to diuretics, the use of CD compared to SF offers the same results of renal recovery, diuresis, vascular decongestion and adverse events, and it can be considered an alternative treatment.