Delayed Renal Allograft Function and Furosemide Treatment (DRAFFT)
Delayed Graft Function
About this trial
This is an interventional treatment trial for Delayed Graft Function focused on measuring Renal transplant, Kidney transplant, DGF
Eligibility Criteria
Inclusion Criteria:
- Age ≥ 18 years
- Patient with ESRD who has been on RRT (Hemodialysis or Peritoneal dialysis)
- Recipient of deceased donor kidney transplant
- Urine output less than 0.5 mL/kg/h before transplant
- Patient consents to the study
- Patient is not allergic to furosemide or sulfa
- English or Spanish speaking patient
- Patient is oliguric (urine output less than 0.5mL/kg/h, as per AKIN criteria) or anuric (urine output less than 10 mL in 6 hours post-transplant or 2 mL/h) in the first 6 hours post kidney transplant
Exclusion Criteria:
- Recipients of a living donor kidney transplant
- Patients who do not consent for the study
- Patients age <18 years
- Patients who are allergic to furosemide or sulfa containing medications
- Non-oliguric patients
- Patients who require immediate dialysis within 6 hours of the transplant (before enrollment)
- Patients with renal ischemia due to vascular compromise that has been confirmed with Doppler Ultrasound right after transplant as per standard of care
- Patients who return to the operating room due to complications within 24 hours
- Simultaneous multi-organ transplant recipients
- Hypotensive patients with BP <90/60 or MAP <60 mmHg
- Patients who are on vasopressors at any time during study period
- Non-English or Spanish speaking patient
Sites / Locations
- Loma Linda University Medical Center
Arms of the Study
Arm 1
Arm 2
Active Comparator
Placebo Comparator
Furosemide
Saline
Patients assigned to the furosemide infusion group will receive furosemide infusions, as outlined in figure 2. This has been adapted from Ostermann et al. (2007) and the SPARK study protocol (Bagshaw et al. 2010). Furosemide will be prepared in bags that contain 1000 mg of furosemide per 250 mL of saline reaching a concentration of 4 mg/mL. All medication and placebo bags will have no identifiers that show what type of drug is being administered, for blinding purposes. Medication and placebo bags will have randomly generated study identifier numbers. The protocol in figure 2 will be followed to achieve a total urine output of 1mL/kg/h. The furosemide infusion rate will not exceed 4mg/min IV as this is the maximum set by the manufacturer.
All patients assigned to the saline group will receive saline that is equal in volume as compared to the treatment group. The amount of saline given to the patients in the placebo arm is so small that its effect on these patients is negligible. All other aspects of care for the enrolled patient will be managed per primary team and any consultants.