Differential effect on mortality of the timing of initiation of renal replacement therapy according to the criteria used to diagnose acute kidney injury: an IDEAL-ICU substudy
Authors' conclusion
The timing of RRT initiation has a differential impact on outcome according to AKI diagnostic criteria. In patients with elevated creatinine only, early RRT initiation was associated with significantly increased mortality. In patients with reduced urine output only, late RRT initiation was associated with a nonsignificant, 10% absolute increase in mortality.
Study context
- Population
- Patients with early-stage septic shock and acute kidney injury (AKI), by AKI criterion: creatinine elevation only (group 1, n=205), reduced urinary output only (group 2, n=174), both (group 3, n=100)enrolled
- Participants
- 488 patients
- Comparison
- Early vs delayed renal replacement therapy (RRT) initiation, by AKI diagnostic criterion
- Primary endpoint
- All-cause death
- Follow-up
- 90 days
Methodological detailssubgroup analysis
- Subgroup analysis
Primary result
As reported in the abstract
90-day mortality by AKI criterion group
Significant heterogeneity of RRT strategy effect across groups
adjusted interaction p = 0.021
Secondary outcomes
RRT-free days, RRT dependence, renal function at discharge
- No significant difference in secondary outcomes
Original publication
Differential effect on mortality of the timing of initiation of renal replacement therapy according to the criteria used to diagnose acute kidney injury: an IDEAL-ICU substudy. Crit Care. Published 17 August 2023. doi:10.
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