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No significant difference in mortality for patients with AKI, sepsis with early vs delayed renal replacement therapy
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No significant difference regarding overall mortality at 90 days was seen for patients with septic shock who had severe acute kidney injury and were assigned to early strategy renal replacement therapy compared with those assigned to a delayed strategy, according to a published study.
Researchers performed a randomized controlled trial of 488 patients with early stage septic shock who had severe AKI at the failure stage of the risk, injury, failure, loss and ESKD classification system but without life-threatening complications related to AKI. Patients were assigned to receive renal replacement therapy either within 12 hours after documentation of failure-stage AKI or after a delay of 48 hours if renal recovery did not occur. Death at 90 days was the primary outcome.
Investigators noted the trial ended early due to futility after the second planned interim analysis. No significant differences between the groups were seen at baseline with regard to characteristics.
At 90 days, there were 477 patients with follow-up data. Investigators found 58% of patients in the early strategy group and 54% of patients in the delayed strategy group died. There were 38% of delayed strategy patients who did not receive renal replacement therapy. In the delayed strategy group, criteria for emergency renal replacement therapy were met in 17% of patients. – by Monica Jaramillo
Disclosures: The authors report no relevant financial disclosures.
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