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Table 3 Six major randomized controlled trials included in sensitivity analysis for examination of the watchful waiting strategy

From: Comparison between watchful waiting strategy and early initiation of renal replacement therapy in the critically ill acute kidney injury population: an updated systematic review and meta-analysis

Trial, year

Jamale 2013

STARRT-AKI pilot 2015

ELAIN-2016

AKIKI-2016

IDEAL-ICU 2018

The FST trial 2018

Population, N

Mixed, 208 (only 3 surgical)

Mixed, 100 (56% sepsis)

Surgical, 231

Mixed, 619 (80% medical)

Medical, 488 (septic shock)

Mixed, 118 (67% medical)

Inclusion criteria

AKI

Urea > 70 mg/dL or creatinine > 7 mg/dL

Severe AKI (any 2 criteria):

(1) 2× increase Cr

(2) UOP < 6 mL/kg/12 h

(3) blood NGAL ≥ 400 ng/mL)

KDIGO stage 2 and plasma NGAL > 150 ng/mL and (any one):

(1) Severe sepsis

(2) Catecholamine

(3) Refractory fluid overload

(4) Non-renal organ failure, SOFA ≥ 2

KDIGO stage 3

RIFLE-F stage and septic shock within 48 h

AKI (KDIGO) and

(1) Clinical diagnosis of ATN and

(2) FST nonresponsive: urine output < 200 ml for 2 h

NGAL level

NR

400 ng/mL

Median: > 1300 ng/mL

> 150 ng/mL

Median

490 ng/mL (early)

618 ng/mL (late)

NR

NR

≥ 150 ng/mL

Median

625 ng/mL (early)

860 ng/mL (late)

Other late criteria in addition to conventional indication

Nil

Nil

AKI progression (KDIGO stage 2 to 3)

AKI non-recovery (oliguria/anuria) > 72 h)

AKI non-recovery (UOP < 1000 in diuretics naive or < 2000 with diuretics) > 48 h

Nil

Late group median from randomization to RRT (IQR), hours

NR

31.57 (22.83–59.50)

Mean and SD: 51.63 h (51.95)

25.5 (18.8, 40.3)

Mean and SD: 40.0 h (54.5)

57 (28–53)

51.5 (34.6–59.5)

21 (16.75–48.5)

Mortality (event/number)

21/102 vs. 13/106 (90 days)

18/48 vs. 19/52 (90 days)

44/112 vs. 65/119 (90 days)

150/311 vs. 153/308 (60 days)

138/246 vs. 128/242 (60 days)

36/58 vs. 35/60 (28 days)

  1. AKI acute kidney injury; ATN acute tubular necrosis; Cr creatinine; FST furosemide stress test; IQR interquartile range; KDIGO Kidney Disease: Improving Global Outcomes; NGAL neutrophil gelatinase-associated lipocalin; NR not reported; RIFLE risk, injury, failure, loss, end-stage kidney disease; SD standard deviation; UOP urine output