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The effect of starting dialysis earlier than usual in patients with damaged kidneys

Not Applicable
Completed
Conditions
Acute kidney injury
Urological and Genital Diseases
Registration Number
ISRCTN13470139
Lead Sponsor
niversity of Toronto
Brief Summary

2020 Results article in https://doi.org/10.1056/NEJMoa2000741 (added 18/11/2022)

Detailed Description

Not available

Recruitment & Eligibility

Status
Completed
Sex
All
Target Recruitment
2927
Inclusion Criteria

1. Age =18 years
2. Admission to an intensive care unit (ICU)
3. Evidence of kidney dysfunction [serum creatinine =100 µmol/L in women and = 130 µmol/L in men]
4. Evidence of severe AKI

Exclusion Criteria

1. Lack of commitment to provide RRT as part of limitation of ongoing life support.
2. Presence of a drug overdose that necessitates initiation of RRT.
3. Any RRT within the previous 2 months.
4. Kidney transplant within the past 365 days.
5. Known pre-hospitalization advanced chronic kidney disease, defined by an estimated glomerular filtration rate <20 mL/min/1.73 m2 in a patient who is not on chronic dialysis.
6. Presence or clinical suspicion of renal obstruction, rapidly progressive glomerulonephritis, vasculitis, thrombotic microangiopathy (eg, thrombotic thrombocytopenic purpura, hemolytic uremic syndrome, malignant hypertension, scleroderma renal crisis) or acute interstitial nephritis.
7. Likelihood that an absolute indication for RRT will arise in the subsequent 24 hours based on the most recent blood work for the following parameters: serum K >5.5
8. Likelihood that an absolute indication for RRT will arise in the subsequent 24 hours based on the most recent blood work for the following parameters: serum bicarbonate <15 mmol/

Study & Design

Study Type
Interventional
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Mortality measured at 90 days
Secondary Outcome Measures
NameTimeMethod
Recovery of kidney function defined as independence from dialysis at 90 days
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