Table 1.
Characteristics of included comparative studies
| References | Population setting and site | Nation, continence | Patients (early/late) | WWS* | Age | Male (%) | HTN/DM/HF/CKD (%) | Sepsis (%) | Definition of "Accelerated" | Definition of "Standard" | RRT modality | Primary outcome |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Bouman et al. [16] | Multi-center mixed | Netherland | 71 (35/36) | Yes | 68.4 | 59.2 | NA | N/A | Within 12 h after fulfilling the following criteria: UOP < 30 mL/h and CCr < 20 mL/min on 3-h sample | When the patient fulfilled the conventional criteria for RRT: BUN > 40 mmol/L, K > 6.5 mmol/L or severe pulmonary edema (CVP or pulmonary artery occlusion pressure of 16 mm Hg and lung edema with positive end expiratory pressure of 10 cm H2O and PO2/FIO2 ratio of 150 mm Hg | CRRT | In-hospital mortality, In-ICU mortality, 28-day mortality |
| Sugahara et al. [17] | Single-center, surgical | Japan | 28 (14/14) | No | 64.5 | 64.3 | 57.0/38.5/NA/NA | N/A | Within 12 h of UOP < 30 mL/h or < 750 mL/day | After 12 h of UOP < 20 mL/h or urine output < 500 mL/day | CRRT | 14-day mortality |
| Wald et al. [18] | Multi-center, mixed | Canada | 100 (48/52) | Yes | 63.1 | 72.0 | 53.0/39.0/11.0/NA | 56.0 | Within 12 h of fulfilling eligibility: at least two of the following: twofold increase in serum Cr from baseline; UOP < 6 mL/kg in the preceding 12 h; whole-blood NGAL > 400 ng/mL | Severe hyperkalemia (> 6 mmol/L); severe pulmonary edema; severe metabolic acidosis (serum bicarbonate < 10 mmol/L) | Mixed (IHD/CRRT/SLED) | In-hospital mortality; In-ICU mortality; 90-day mortality |
| Zarbock et al. [19] | Single-center, surgical | Germany | 231 (112/119) | Yes | 67.0 | 63.2 | 81.8/19.5/41.6/40.7 | 32.5 | KDIGO Stage 2 AKI (within 8 h) and plasma NGAL > 150 ng/mL | KDIGO stage 3 | CRRT | 30-/60-/90-day mortality |
| Gaudry et al. [7] | Multi-center, mixed | France | 619 (311/308) | Yes | 66.2 | 65.4 | 53.0/26.3%/9.0/9.7 | 79.8 | KDIGO Stage 3 AKI (within 6 h) | Severe hyperkalemia (> 6 mmol/L); severe pulmonary edema refractory to diuretics; severe acidosis (pH < 7.15); serum urea > 40 mmol/L; oligo-anuria > 72 h | Mixed (IHD/CRRT) | 60-/90-day mortality |
| Srisawat et al. [20] | Single-center, mixed | Thailand | 40 (20/20) | Yes | 66.8 | 55.0 | NA | 72.5 | AKI, any RIFLE stage | Severe metabolic acidosis (pH < 7–20); severe hyperkalemia (> 6 2 mmol/L); severe pulmonary edema refractory to diuretics; persistent oliguria or anuria; serum urea > 40 mg/dL | CRRT | 28-day mortality |
| Lumlertgul et al. [21] | Multicenter, mixed | Thailand | 118 (58/60) | Yes | 67.1 | 46.2 | 44.9/24.6/NA/NA | 58.5 | Furosemide stress test-nonresponsive patients (UOP < 200 mL in 2 h) (initiation within 6 h); AKI (any stage of KDIGO) | Serum urea > 100 mg/dL; severe hyperkalemia (> 6 mmol/L); severe metabolic acidosis (pH < 715); severe pulmonary edema | CRRT | 28-day mortality |
| Barbar et al. [8] | Multicenter, mixed | France | 477 (239/238) | Yes | 69.0 | 60.7 | 57.8/30.5/8.2/15.6 | 100.0 | Within 12 h after documentation of RIFLE-F | Severe hyperkalemia (> 6 5 mmol/L); severe pulmonary edema refractory to diuretics; severe metabolic acidosis (pH < 715); no renal function recovery after 48 h | Mixed | 90-day mortality |
| Yang et al. [22] | Single-center, mixed | China | 142 (71/71) | No | 56.7 | 58.5 | 37.3/45.8/NA/NA | 100 | Within 24 h of ICU entry | After 48 h of ICU entry | CRRT | 28-day mortality |
| STARRT-AKI [9] | Multicenter, mixed | Multiple | 2927 (1465/1462) | Yes | 64.7 | 68.0 | 55.9/30.7/13.9/43.9 | 57.7 | Within 12 h of fulfilling eligibility: at least two of the following: twofold increase in serum Cr from baseline; UOP < 6 mL/kg in the preceding 12 h; whole-blood NGAL > 400 ng/mL | Until the development of one or more of the following criteria: a serum potassium level > 6.0 mmol/L, a pH < 7.20 or a serum bicarbonate < 12 mmol/L, severe respiratory failure based on a ratio of the partial pressure of arterial oxygen to the fraction of inspired oxygen of < 200 and clinical perception of volume overload, or persistent AKI for at least 72 h after randomization | Mixed | 90-day mortality |
AKI, acute kidney injury; CCr, creatinine clearance rate; CKD, chronic kidney disease; Cr, creatinine; CRRT, continuous renal replacement therapy; DM, diabetic mellitus; HTN, hypertension; HF, heart failure; ICU, intensive care unit; IHD. Intermittent hemodialysis; KDIGO, Kidney Disease Improving Global Outcomes; N/A, not available; NGAL, neutrophil gelatinase-associated lipocalin; pre-OP, pre-operation; RIFLE, Risk, Injury, Failure, Loss of kidney function, and End-stage kidney disease; RRT, renal replacement therapy; SLED, Sustained low efficiency dialysis; UOP, urine output; WWS, watchful waiting strategy
*Study design with watchful waiting strategy