Trial reportAmerican journal of respiratory and critical care medicine2018
Timing of Renal Support and Outcome of Septic Shock and Acute Respiratory Distress Syndrome. A Post Hoc Analysis of the AKIKI Randomized Clinical Trial.
Trial report in American journal of respiratory and critical care medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 46 papers, 3 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
46 citing papers in PubMed, 3 syntheses or guidelines pooled it, 76 citations in OpenAlex.
- Sodium bicarbonate therapy in severe metabolic acidemia: an individual patient data meta-analysis of the BICAR-ICU and BICAR-ICU2 trials.Critical care (London, England) · 2026Pooled it
- Timing of renal-replacement therapy in patients with acute kidney injury and sepsis: a systematic review and meta-analysis.BMC nephrology · 2026Pooled it
- Timing of kidney replacement therapy initiation for acute kidney injury.The Cochrane database of systematic reviews · 2022Pooled it
- Decoding lung-kidney interactions in sepsis: an integrated view of molecular mechanisms, pathophysiology, and therapeutic interventions.Frontiers in immunology · 2026Review
- Organ Crosstalk During Injury: Mechanisms of Lung-Kidney Interaction in Critical Illness.Comprehensive Physiology · 2025Review
- Early Versus Late Dialysis in Cirrhosis Patients and Septic Shock (ELDICS Study): A Randomized Controlled Trial (NCT02937961).JGH open : an open access journal of gastroenterology and hepatology · 2025Article
- The Furosemide Stress Test: A Dynamic Tool for Predicting Acute Kidney Injury Progression in Critical Care Medicine.Journal of clinical medicine · 2025Review
- Time-Limited Trials in Intensive Care Medicine: A Tool for Avoiding Inappropriate Treatment.Deutsches Arzteblatt international · 2025Review
- The impact of initiation timing of continuous renal replacement therapy on outcomes in critically ill patients with acute kidney injury a retrospective study from the MIMIC-IV database.Scientific reports · 2025Article
- Severe community-acquired pneumonia compared to severe community-acquired Acinetobacter baumannii pneumonia in Reunion Island: A retrospective study.Tropical medicine & international health : TM & IH · 2025Article
- Urinary proteomics identifies distinct immunological profiles of sepsis associated AKI sub-phenotypes.Critical care (London, England) · 2024Article
- Early goal-directed renal replacement therapy in severe pneumonia associated acute kidney injury.Renal failure · 2024Article
- Case Report: Severe Community-Acquired Pneumonia in Réunion Island due to Acinetobacter baumannii.The American journal of tropical medicine and hygiene · 2024Article
- Comparison of diagnostic criteria for sepsis-associated acute kidney injury in the pediatric intensive care unit: a retrospective cohort study.Translational pediatrics · 2024Article
- Meaning and Management of Perioperative Oliguria.Anesthesiology · 2024Article
- The effects of timing onset and progression of AKI on the clinical outcomes in AKI patients with sepsis: a prospective multicenter cohort study.Renal failure · 2023Article
- The benefits of early continuous renal replacement therapy in critically ill patients with acute kidney injury at high-altitude areas: a retrospective multi-center cohort study.Scientific reports · 2023Article
- Current management of fluid balance in critically ill patients with acute kidney injury: A scoping review.Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2023Article
- Organ Crosstalk in Acute Kidney Injury: Evidence and Mechanisms.Journal of clinical medicine · 2022Review
- Timely renal replacement therapy linked to better outcome in patients with sepsis-associated acute kidney injury.Journal of intensive medicine · 2022Article
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Authors and funding
26 authors at 19 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
rationaleThe optimal strategy for initiation of renal replacement therapy (RRT) in patients with severe acute kidney injury in the context of septic shock and acute respiratory distress syndrome (ARDS) is unknown.
objectivesTo examine the effect of an early compared with a delayed RRT initiation strategy on 60-day mortality according to baseline sepsis status, ARDS status, and severity.
methodsPost hoc analysis of the AKIKI (Artificial Kidney Initiation in Kidney Injury) trial. MEASUREMENTS AND MAIN
resultsSubgroups were defined according to baseline characteristics: sepsis status (Sepsis-3 definition), ARDS status (Berlin definition), Simplified Acute Physiology Score 3 (SAPS 3), and Sepsis-related Organ Failure Assessment (SOFA). Of 619 patients, 348 (56%) had septic shock and 207 (33%) had ARDS. We found no significant influence of the baseline sepsis status (P = 0.28), baseline ARDS status (P = 0.94), and baseline severity scores (P = 0.77 and P = 0.46 for SAPS 3 and SOFA, respectively) on the comparison of 60-day mortality according to RRT initiation strategy. A delayed RRT initiation strategy allowed 45% of patients with septic shock and 46% of patients with ARDS to escape RRT. Urine output was higher in the delayed group. Renal function recovery occurred earlier with the delayed RRT strategy in patients with septic shock or ARDS (P < 0.001 and P = 0.003, respectively). Time to successful extubation in patients with ARDS was not affected by RRT strategy (P = 0.43).
conclusionsEarly RRT initiation strategy was not associated with any improvement of 60-day mortality in patients with severe acute kidney injury and septic shock or ARDS. Unnecessary and potentially risky procedures might often be avoided in these fragile populations. Clinical trial registered with www.clinicaltrials.gov (NCT 01932190).
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