6/29/23, 11:45 PM STARRT-AKI (secondary analysis, CKD) Pathway Feedback Search Clinical Topics Home Studies STARRT AKI (secondary analysis, CKD STARRT AKI (secondary analysis, CKD Disease Disease Acute kidney injury Chronic kidney disease Trial question What is the effect of RRT initiation strategy in patients with and without CKD? 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=689 renal-replacement therapy for patients with CKD (eGFR 59 mL/min/1.73 m ) N=432 renal-replacement therapy for patients without CKD (eGFR > 59 mL/min/1.73 m ) Primary outcome Death from all causes at day 90 47.2 47.2 % 39.5 https://web.pathway.md/studies/rec04XqwVz6tMXTTR 1/2 6/29/23, 11:45 PM STARRT-AKI (secondary analysis, CKD) Pathway 39.5 35.4 % 23.6 % 11.8 % No significant difference 0.0 % Renal-replacement therapy for patients with chronic kidney disease Renal-replacement therapy for patients without chronic kidney disease No significant difference in death from all causes at day 90 (47.2% vs. 39.5%; aOR 1.05, 95% CI 0.79 to 1.41) Secondary outcomes Significant increase in RRT dependence at day 90 (13.7% vs. 7.7%; aOR 1.89, 95% CI 1.05 to 3.43) No significant difference in RRT-free days at day 90 (39.7 days vs. 47.9 days; MD -3.24, 95% CI -8.3 to 1.82) No significant difference in death in the hospital (40.6% vs. 35.6%; OR 1.03, 95% CI 0.76 to 1.37) Safety outcomes No significant difference in adverse events. Conclusion In patients with documented pre-existing eGFR data prior to hospitalization, renal-replacement therapy for patients with CKD was not superior to renal-replacement therapy for patients without CKD with respect to death from all causes 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/rec04XqwVz6tMXTTR 2/2