ELAIN

Early versus Late Initiation of Renal Replacement Therapy in AKI

Patient / Population Intervention / Exposure Comparison Outcome

In 231 critically ill patients with acute kidney injury, early renal-replacement therapy reduced 90-day mortality compared with delayed initiation.

231

Design

Single-centre RCT

Endpoint

90-day all-cause mortality

Relevance

Result39.3% vs 54.7%; HR 0.66 (95% CI 0.45–0.97; p=0.03).

Zarbock A, et al. JAMA. 2016;315(20):2190-2199. 10.1001/jama.2016.5828

Discussion & critique

Positive but single-centre with a fragility index of 3; contradicted by larger multicentre trials.