Immediate or delayed initiation of renal replacement therapy in patients with leptospirosis and acute kidney injury: a target trial emulation
Authors' conclusion
Early initiation of RRT may be associated with an increased risk of death and development of CKD within 1 year in patients with leptospirosis and Stage 3 AKI.
Study context
- Population
- Patients hospitalised with leptospirosis, Stage 3 AKI and no immediate need for renal replacement therapy (RRT), two academic centres, La Réunion, France, 2010–2020
- Participants
- 295 consecutive patients
- Exposure
- Early vs delayed RRT initiation
- Earlyn = 82
- Delayedn = 213reference
Methodological detailsretrospective cohort study, propensity score-weighted logistic regression, two academic centres, consecutive patients
- Retrospective cohort study
- Propensity score-weighted logistic regression
- Two academic centres
- Consecutive patients
Main finding
As reported in the abstract
Early vs DelayedOdds ratio (95% CI)P value
After weighting
2.08(1.01–4.26)
P = 0.046Before weighting
2.78(1.53–5.01)
P < 0.001Observational data: associations, not effects.
Further findings
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| CKD occurrence | 2.74 (1.25–6.0) | P = 0.012 | |
| 0.20.5125Odds ratio (log scale) |
Mortality · 1 year
- Did not differ between groups (OR 0.76, 95% CI 0.21 to 2.68, p = 0.666)
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Immediate or delayed initiation of renal replacement therapy in patients with leptospirosis and acute kidney injury: a target trial emulation. Ann Intensive Care. Published 14 May 2025. doi:10.
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