ArticleClinical journal of the American Society of Nephrology : CJASN2008
Lessons for successful study enrollment from the Veterans Affairs/National Institutes of Health Acute Renal Failure Trial Network Study.
Article in Clinical journal of the American Society of Nephrology : CJASN, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 4 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
12 citing papers in PubMed, 4 syntheses or guidelines pooled it, 32 citations in OpenAlex.
- Timing of kidney replacement therapy initiation for acute kidney injury.The Cochrane database of systematic reviews · 2022Pooled it
- Non-pharmacological interventions for preventing clotting of extracorporeal circuits during continuous renal replacement therapy.The Cochrane database of systematic reviews · 2021Pooled it
- Timing of renal replacement therapy initiation for acute kidney injury.The Cochrane database of systematic reviews · 2018Pooled it
- Intensity of continuous renal replacement therapy for acute kidney injury.The Cochrane database of systematic reviews · 2016Pooled it
- Intermittent high-volume predilution on-line haemofiltration versus standard intermittent haemodialysis in critically ill patients with acute kidney injury: a prospective randomized study.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2012Trial
- Intensity of renal support in critically ill patients with acute kidney injury.The New England journal of medicine · 2008Trial
- Predicting Renal Recovery After Dialysis-Requiring Acute Kidney Injury.Kidney international reports · 2019Article
- Review
- Renal Replacement Therapy and Incremental Hemodialysis for Veterans with Advanced Chronic Kidney Disease.Seminars in dialysis · 2017Review
- Strategies to Maximize Enrollment in a Prospective Study of Comatose Children in the PICU.Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2016Article
- Using real-time alerts for clinical trials: Identifying potential study subjects.Applied clinical informatics · 2011Article
- Intensity of renal replacement therapy in acute kidney injury: perspective from within the Acute Renal Failure Trial Network Study.Critical care (London, England) · 2009Article
Corrections and comments
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Authors and funding
12 authors at 8 institutions in 1 country.
Funding
Abstract
BACKGROUND AND
objectivesDesign elements of clinical trials can introduce recruitment bias and reduce study efficiency. Trials involving the critically ill may be particularly prone to design-related inefficiencies. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Enrollment into the Veterans Affairs/National Institutes of Health Acute Renal Failure Trial Network Study was systematically monitored. Reasons for nonenrollment into this study comparing strategies of renal replacement therapy in critically ill patients with acute kidney injury were categorized as modifiable or nonmodifiable.
results4339 patients were screened; 2744 fulfilled inclusion criteria. Of these, 1034 were ineligible by exclusion criteria. Of the remaining 1710 patients, 1124 (65.7%) enrolled. Impediments to informed consent excluded 21.4% of potentially eligible patients. Delayed identification of potential patients, physician refusal, and involvement in competing trials accounted for 4.4, 2.7, and 2.3% of exclusions. Comfort measures only status, chronic illness, chronic kidney disease, and obesity excluded 11.8, 7.8, 7.6, and 5.9% of potential patients. Modification of an enrollment window reduced the loss of patients from 6.6 to 2.3%.
conclusionsThe Acute Renal Failure Trial Network Study's enrollment efficiency compared favorably with previous intensive care unit intervention trials and supports the representativeness of its enrolled population. Impediments to informed consent highlight the need for nontraditional acquisition methods. Restrictive enrollment windows may hamper recruitment but can be effectively modified. The low rate of physician refusal acknowledges clinical equipoise in the study design. Underlying comorbidities are important design considerations for future trials that involve the critically ill with acute kidney injury.
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