Ron Wald, Neill K J Adhikari, Orla M Smith, Matthew A Weir, Karen Pope, Ashley Cohen, Kevin Thorpe, Lauralyn McIntyre, Francois Lamontagne, Mark Soth, Margaret Herridge, Stephen Lapinsky, Edward Clark, Amit X Garg, Swapnil Hiremath, David Klein, C David Mazer, Robert M A Richardson, M Elizabeth Wilcox, Jan O Friedrich, Karen E A Burns, Sean M Bagshaw
In patients with severe acute kidney injury (AKI) but no urgent indication for renal replacement therapy (RRT), the optimal time to initiate RRT remains controversial. While starting RRT preemptively may have benefits, this may expose patients to unnecessary RRT. To study this, we conducted a 12-center open-label pilot trial of critically ill adults with volume replete severe AKI. Patients were randomized to accelerated (12 h or less from eligibility) or standard RRT initiation. Outcomes were adherence to protocol-defined time windows for RRT initiation (primary), proportion of eligible patients enrolled, follow-up to 90 days, and safety in 101 fully eligible patients (57 with sepsis) with a mean age of 63 years...
October 2015: Kidney International