May 29, 2016

Effect of Early vs Delayed Initiation of Renal Replacement Therapy on Mortality in Critically Ill Patients With Acute Kidney Injury The ELAIN Randomized Clinical Trial

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This single-center randomized clinical trial of 231 critically ill patients with AKI KDIGO stage 2 looked at early (within 8 hours of diagnosis of KDIGO stage 2; n = 112) or delayed (within 12 hours of stage 3 AKI or no initiation; n = 119) initiation of RRT.  The results show that early initiation of RRT significantly reduced 90-day mortality (39.3% vs 54.7%).  More patients in the early group recovered renal function by day 90 (53.6% vs 38.7%) in the delayed group.  Furthermore, duration of RRT and length of hospital stay were significantly shorter in the early group than in the delayed group but there was no significant effect on requirement of RRT after day 90, organ dysfunction, and length of ICU stay.

Related Articles:

Acute Kidney Injury, Clinical Trial Results, Hemodialysis