6/29/23, 11:45 PM STARRT-AKI (secondary analysis, accelerated RRT) Pathway Feedback Search Clinical Topics Home Studies STARRT AKI (secondary analysis, accelerated RRT STARRT AKI (secondary analysis, accelerated RRT Disease Disease Acute kidney injury Chronic kidney disease Trial question What is the effect of accelerated RRT initiation in patients with pre-hospital measures of kidney function? Study design Multi-center Open label RCT Population Characteristics of study participants 31.0% female N = 1121 69.0% male 1121 patients (353 female, 768 male) Inclusion criteria: patients with documented pre-existing eGFR data prior to hospitalization Key exclusion criteria: eGFR < 20 mL/min/1.73 m Interventions N=561 accelerated strategy (initiation of RRT within 12 hours) N=560 standard strategy (RRT initiation discouraged until development of conventional indications or persistent AKI for 72 hours) Primary outcome Death in patients with chronic kidney disease at day 90 https://web.pathway.md/studies/recAzAUhW9ZwdFnVO 1/2 6/29/23, 11:45 PM STARRT-AKI (secondary analysis, accelerated RRT) Pathway 47.4 % 47.4 47 35.5 % 23.7 % 11.8 % No significant difference 0.0 % Accelerated strategy Standard strategy No significant difference in death in patients with CKD at day 90 (47% vs. 47.4%; OR 0.98, 95% CI 0.67 to 1.44) Secondary outcomes No significant difference in death in patients without CKD at day 90 (40.9% vs. 38%; OR 1.13, 95% CI 0.83 to 1.53) Borderline significant increase in RRT dependence in patients with CKD at day 90 (19.8% vs. 7.2%; OR 3.18, 95% CI 1.41 to 7.91) No significant difference in RRT dependence in patients without CKD at day 90 (6.5% vs. 8.9%; OR 0.71, 95% CI 0.34 to 1.47) Conclusion In patients with documented pre-existing eGFR data prior to hospitalization, accelerated strategy was not superior to standard strategy with respect to death in patients with CKD at day 90. Reference Sean M Bagshaw, Ary Serpa Neto, Orla Smith et al. Impact of renal-replacement therapy strategies on outcomes for patients with chronic kidney disease: a secondary analysis of the STARRT-AKI trial. Intensive Care Med. 2022 Dec;48(12):1736-1750. Open reference URL https://web.pathway.md/studies/recAzAUhW9ZwdFnVO 2/2