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WEDNESDAY, Oct. 10, 2018 (HealthDay News) — For patients with early-stage septic shock and severe acute kidney injury, 90-day mortality does not differ for patients randomly assigned to an early strategy for initiation of renal-replacement therapy versus a delayed strategy, according to a study published in the Oct. 11 issue of the New England Journal of Medicine<\/i>.<\/p>\n
Saber D. Barbar, M.D., Ph.D., from the Centre Hospitalier Universitaire de N\u00eemes in France, and colleagues conducted a trial involving patients with early-stage septic shock who had severe acute kidney injury at the failure stage of the risk, injury, failure, loss, and end-stage kidney disease classification system. Patients were randomly assigned to receive renal-replacement therapy within 12 hours after documentation of failure-stage acute kidney injury (early strategy) or after a 48-hour delay if renal recovery had not occurred (delayed strategy); follow-up data at 90 days were available for 477 patients.<\/p>\n
After the second planned interim analysis, the trial was stopped early for futility. The researchers found that 58 percent of patients in the early-strategy group and 54 percent in the delayed-strategy group had died (P = 0.38). Thirty-eight percent of patients in the delayed-strategy group did not receive renal-replacement therapy. Seventeen percent of patients in the delayed-strategy group met the criteria for emergency renal-replacement therapy.<\/p>\n
“This trial showed no significant difference in mortality between a strategy of early initiation of renal-replacement therapy and a strategy of delayed initiation,” the authors write.<\/p>\n
Two authors disclosed financial ties to the pharmaceutical industry.<\/p>\n
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