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  • Question 1: Is the use of furosemide beneficial in the treatment of acute kidney injury in the paediatric population including neonates?

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Question 1: Is the use of furosemide beneficial in the treatment of acute kidney injury in the paediatric population including neonates?
  1. Dean Lethaby1,
  2. Job Cyriac2,
  3. Detlef Bockenhauer3
  1. 1 Department of Neonates, Homerton University Hospital, London, UK
  2. 2 Department of Paediatrics, Broomfield Hospital, Chelmsford, UK
  3. 3 Department of Paediatric Nephrology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
  1. Correspondence to Dr Dean Lethaby, Department of Neonates, Homerton University Hospital, Homerto row, London e96sr, UK; deanlethaby{at}googlemail.com

https://doi.org/10.1136/archdischild-2015-308472

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    Scenario 1

    A 2-year-old boy is admitted to the paediatric ward with a significant history of diarrhoea and vomiting, reduced urine output and signs of dehydration on examination. Despite giving adequate fluid replacement and maintenance, his urine output does not improve. Serial blood chemistry and urine analysis confirms evidence of worsening AKI. In this scenario, you wonder if administration of furosemide may help to ‘kick start’ and maintain urine output, ameliorate the need for dialysis and prevent long-term renal insufficiency.

    Structured clinical question

    In paediatric populations including neonates with AKI (Patient), is administration of intravenous furosemide subsequent to adequate intravascular volume replenishment (Intervention) in comparison with an expectant approach after adequate fluid replenishment associated with any short-term or long-term benefits or reduction in renal complications (Outcome)?

    Search strategy and outcome

    No relevant reviews were found in the Cochrane Library. A search in Medline and Embase completed in October 2014 produced 1023 titles using the following entry terms and strategies: [(‘ACUTE KIDNEY INJURY’[Mesh] OR ‘acute renal failure’[tiab]) AND (‘furosemide’[tiab] OR ‘FUROSEMIDE’[Mesh])] AND Limit to: (Age Groups Newborn Infant birth to 1 month or Infant 1 to 23 months or Preschool Child 2 to 5 years)+[(‘ACUTE KIDNEY INJURY’ [Mesh] OR ‘acute renal failure’ [tiab]) AND (ANOXIA [Mesh) OR hypoxi×OR ISCHEMIA [Mesh]] AND Limit …

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    Footnotes

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

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