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 (90Â days) | 18/48 vs. 19/52 (90Â days) | 44/112 vs. 65/119 (90Â days) | 150/311 vs. 153/308 (60Â days) | 138/246 vs. 128/242 (60Â days) | 36/58 vs. 35/60 (28Â days) |