Trial reportIntensive care medicine2022
Impact of renal-replacement therapy strategies on outcomes for patients with chronic kidney disease: a secondary analysis of the STARRT-AKI trial.
Trial report in Intensive care medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 18 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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
18 citing papers in PubMed, 1 synthesis or guideline pooled it.
- [S3 guideline on renal replacement therapy in intensive care medicine : Evidence-based implementation of renal replacement therapy in critically ill patients].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2025Guideline
- Phase-3 trial of recombinant human alkaline phosphatase for patients with sepsis-associated acute kidney injury (REVIVAL).Intensive care medicine · 2024Trial
- Time from acute kidney injury to continuous renal replacement therapy and outcomes in critically ill children.Clinical kidney journal · 2026Article
- Acute kidney injury and chronic kidney disease in the aging critically ill patient.Intensive care medicine · 2026Article
- Kidney health during critical illness or upon major surgery.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2026Article
- Multidisciplinary guidelines on renal replacement therapy in intensive care medicine.Critical care (London, England) · 2026Review
- Does ability and willingness to use continuous RRT improve patient outcomes? A few answers, plenty of questions and opportunities for research.Intensive care medicine · 2025Article
- Professor Rinaldo Bellomo: Founder, architect, and choreographer of critical care nephrology.Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2025Review
- Renal perfusion pressure: role and implications in critical illness.Annals of intensive care · 2025Review
- State of the art: Renal recovery after AKI - from basic science to clinical practice.Intensive care medicine · 2025Review
- Timing of initiating renal replacement therapy in acute kidney injury.Journal of intensive medicine · 2025Article
- Acute kidney injury: when and how to start renal replacement therapy.Intensive care medicine · 2025Article
- Incidence of major adverse kidney events after ICU admission in COVID-19 and non-COVID-19 ARDS patients.BMJ open · 2025Article
- The kidney: the critical organ system for guiding nutrition therapy in the ICU-patient?Critical care (London, England) · 2024Article
- [Recent developments in acute kidney injury : Definition, biomarkers, subphenotypes, and management].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2024Review
- Major Adverse Kidney Events in Pediatric Continuous Kidney Replacement Therapy.JAMA network open · 2024Article
- Sepsis-associated acute kidney injury in the intensive care unit: incidence, patient characteristics, timing, trajectory, treatment, and associated outcomes. A multicenter, observational study.Intensive care medicine · 2023Observational
- Acute kidney injury.Intensive care medicine · 2023Article
Corrections and comments
- Erratum issued
Authors and funding
11 authors.
Funding
Abstract
purposeTo assess whether pre-existing chronic kidney disease (CKD) modified the relationship between the strategy for renal-replacement theraphy (RRT) initiation and clinical outcomes in the STARRT-AKI trial.
methodsThis was a secondary analysis of a multi-national randomized trial. We included patients who had documented pre-existing estimated glomerular filtration rate (eGFR) data prior to hospitalization, and we defined CKD as an eGFR ≤ 59 mL/min/1.73 m
resultsWe studied 1121 patients who had pre-hospital measures of kidney function. Of these, 432 patients (38.5%) had CKD. The median (IQR) baseline serum creatinine was 130 (114-160) and 76 (64-90) µmol/L for those with and without CKD, respectively. Patients with CKD were older and more likely to have cardiovascular comorbidities and diabetes mellitus. Patients with CKD had higher 90-day mortality (47% vs. 40%, p < 0.001) compared to those without CKD, though this was not significant after covariate adjustment (adjusted odds ratio [aOR], 1.05; 95% CI, 0.79-1.41). Patients with CKD were more likely to remain RRT dependent at 90 days (14% vs. 8%; aOR, 1.89; 95% CI, 1.05-3.43). CKD status did not modify the effect of RRT initiation strategy on 90-day mortality. Among patients with CKD, allocation to the accelerated strategy conferred more than threefold greater odds of RRT dependence at 90 days (aOR 3.18; 95% CI, 1.41-7.91) compared with the standard strategy, whereas RRT initiation strategy had no effect on this outcome among those without CKD (aOR 0.71; 95% CI, 0.34-1.47, p value for interaction, 0.009).
conclusionIn this secondary analysis of the STARRT-AKI trial, an accelerated strategy of RRT initiation conferred a higher risk of 90-day RRT dependence among patients with pre-existing CKD; however, no effect was observed in the absence of CKD.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.