Determine if patients meet criteria for the STARRT-AKI study.
The optimal timing of renal replacement therapy initiation in patients with severe acute kidney injury remains uncertain, representing an important knowledge gap and a priority for high-quality research. STARRT-AKI is a study designed to determine whether early vs deferred initiation of renal replacement therapy offers clinical advantage.
Inclusion criteria include:
Exclusion criteria include:
Provisionally eligible patients must be reviewed by the attending clinicians. If the attending clinicians reviews a provisionally eligible patient and agrees with either of the following, then the patient is excluded: i) Renal replacement therapy must be initiated immediately OR ii) RRT must be deferred, then the patient is excluded. Otherwise, the patient is fully eligible to enroll in STARRT- AKI. Patients excluded after clinician review can be reassessed if the clinician reconsiders and RRT has not yet been started.
Post-Randomization: RRT Initiation Procedure
RRT initiation procedure after randomization depends on the arm to which the patient has been randomized, as described below:
A) Accelerated RRT Initiation:
B) Standard RRT Initiation:
RRT may still be commenced at any time based on clinical judgment, however RRT initiation within 12 hours will be considered a protocol violation
Follow-up Procedures for Both Arms
Guidance for RRT Prescription
IHD:
SLED:
CRRT:
Smith OM, Wald R, Adhikari NK, Pope K, Weir MA, Bagshaw SM.
The optimal timing of renal replacement therapy initiation in patients with severe acute kidney injury remains uncertain, representing an important knowledge gap and a priority for high-quality research. STARRT-AKI is a study designed to determine whether early vs deferred initiation of renal replacement therapy offers clinical advantage.
Inclusion criteria include:
Exclusion criteria include:
Provisionally eligible patients must be reviewed by the attending clinicians. If the attending clinicians reviews a provisionally eligible patient and agrees with either of the following, then the patient is excluded: i) Renal replacement therapy must be initiated immediately OR ii) RRT must be deferred, then the patient is excluded. Otherwise, the patient is fully eligible to enroll in STARRT- AKI. Patients excluded after clinician review can be reassessed if the clinician reconsiders and RRT has not yet been started.
Post-Randomization: RRT Initiation Procedure
RRT initiation procedure after randomization depends on the arm to which the patient has been randomized, as described below:
A) Accelerated RRT Initiation:
B) Standard RRT Initiation:
RRT may still be commenced at any time based on clinical judgment, however RRT initiation within 12 hours will be considered a protocol violation
Follow-up Procedures for Both Arms
Guidance for RRT Prescription
IHD:
SLED:
CRRT:
Smith OM, Wald R, Adhikari NK, Pope K, Weir MA, Bagshaw SM.
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