Discussion
AKI, malignancy, critically ill
CELL INJURY, CRITICALLY ILL, COMPLICATIONS
In recent years, there has been increasing interest in using loop diuretics as trials to assess proximal renal tubular cell injury (e.g., FST) and to predict the progression of AKI. In a follow-up study, urine output at 2 h after FST was superior to the individual urinary biomarker in predicting the progression of stages 1 and 2 AKI to stage 3 AKI [As a result, we designed this prospective interventional cohort study with a double-blind design to prevent FST results from interfering with clinicians initiating CRRT decisions and to ensure that both clinicians and patients were unaware of the FST results. From the results of the study, the feasibility of FST in judging the timing of CRRT initiation is proven. The FST standardization study conducted by Chawla and colleagues showed that the use of 1–1.5 mg/kg of furosemide is safe in patients with AKI [Comparing the CRRT group and the non-CRRT group showed a huge difference in urine output at 2 h after FST, which was actually our expected result. The furosemide response has been used to predict renal recovery and stop of RRT in critically ill patients recovering from AKI [Although FST plays a large role in CRRT initiation and risk stratification in early AKI, some studies have found that it still has appropriate predictive value in AKI stage 3 patients. A retrospective study [By identifying potential AKI progression, we can initiate early intervention before life-threatening complications occur. Furthermore, several emerging AKI biomarkers, including tissue inhibitor of metalloproteinases-2 and insulin-like growth factor binding protein-7 (TIMP-2 × IGFBP-7), interleukin-18 (IL-18), and plasma NGAL, have been shown to predict the progression of AKI [This study has some limitations: first, this is a single-center prospective cohort study with a double-blind design that was limited by a small single-center sample size and an offset in sample characteristics (for example, 41.18% of participants had a malignancy). As a result, the study's findings must be validated in a larger sample size and multicenter study. Second, although we designed the RRI, the two groups did not show significant differences. There are also studies showing a limited predictive value of RRI in AKI progression [