STARRT-AKI
Research type
Research Study
Full title
STandard versus Accelerated initiation of Renal Replacement Therapy in Acute Kidney Injury (STARRT-AKI): A Multi-Centre Randomized Controlled Trial
IRAS ID
191390
Contact name
Marlies Ostermann
Contact email
Sponsor organisation
University of Toronto, Applied Health Research Centre (AHRC)
Clinicaltrials.gov Identifier
Duration of Study in the UK
3 years, 4 months, 0 days
Research summary
More than 1 in 2 critically ill patients in the Intensive Care Unit develop acute kidney injury (AKI). A proportion of patients need dialysis treatment, also known as replacement therapy (RRT). The aim of RRT is to remove toxins and excess fluid which may have accumulated because of kidney failure. RRT can be life saving but has side effects. It requires the insertion of a catheter into a large vein in the neck or groin. This can be complicated by bleeding and blood stream infections. In addition, RRT is expensive.
At present it is not clear whether it is best to start RRT only when patients have evidence of severe AKI or whether it is better to initiate RRT earlier, ie. as soon as patients have signs of impaired kidney function.
This study aims to answer this question. Patients in the ICU with early AKI will be randomised to RRT using standard criteria versus accelerated (earlier) RRT. The aim is to find out whether either strategy improves the chances of survival and/or recovery of kidney function. Importantly, if at any stage the treating clinician feels that RRT is mandatory or alternatively should not be started, their judgement will override. Also, there will be no change in any clinical management and no extra blood samples will be taken. We will collect data related to baseline characteristics (age, gender, reason for ICU admission), timing of RRT, hospital outcome, and survival status, health status and degree of kidney function at 90 days and 1 year.
The results of this study will inform clinicians about the optimal time when to commence RRT so that patients receive RRT when they benefit most. The study will also inform clinicians when RRT can be safely withheld without harming the patient.
REC name
London - Camberwell St Giles Research Ethics Committee
REC reference
17/LO/0621
Date of REC Opinion
22 May 2017
REC opinion
Further Information Favourable Opinion