Does Early Renal Replacement Therapy Improve Outcomes in Acute Kidney Injury?

Appropriate timing of renal replacement therapy (RRT) for patients with severe acute kidney injury (AKI) is controversial. In this multicenter study from Canada, researchers identified 100 patients with oliguric severe AKI who were hospitalized in intensive care units but did not yet have urgent indications for RRT (e.g., severe acidosis, hyperkalemia). Patients were randomized to accelerated RRT (i.e., RRT begun ≤12 hours after randomization) or to standard care; patients in the standard-care group underwent RRT only for classic indications (severe acidosis, hyperkalemia, or volume overload) or according to physician judgment as long as RRT was initiated more than 12 hours after randomization.

In the accelerated group, mean serum creatinine…