• Canadian Critical Care Trials Group
    The Canadian Critical Care Trials Group (CCCTG) is a highly collegial group that is dedicated to the pursuit of excellence and advancement of critical care research in Canada.
  • Canadian Critical Care Trials Group
    The CCCTG has are more than 30 research programs underway and over 100 peer-reviewed publications to its credit, with direct impact on clinical practice in critical care.
  • Canadian Critical Care Trials Group
    The Canadian Critical Care Trials Group (CCCTG) is a national organization of more than 300 individuals with research interests in the management of the critically ill patient.
  • Canadian Critical Care Trials Group
    Endorsement by the CCCTG communicates our full commitment to ensure that the work is undertaken in a rigorous and ethical manner, and communicated in a timely and effective way.
Programs

Principal Investigator(s)

Sean Bagshaw, Ron Wald

Coordinator(s)

Janice Jansen-Pereira

Status

Enrolling

STARRT-AKI – Standard vs. Accelerated Renal Replacement Therapy in Critically Ill Patients with Acut

Standard vs. Accelerated Renal Replacement Therapy in Critically Ill Patients with Acute Kidney Injury (STARRT-AKI)

Background:
Acute kidney injury (AKI) is a common complication of critical illness, complicating the hospitalization for up to 67% of patients admitted to the ICU. Importantly, for those critically ill patients with more severe forms of AKI, an estimated 50-70% will require initiation with acute renal replacement therapy (RRT), which represents approximately 5-8% of all critically ill patients. The need for RRT is often accompanied by a considerable escalation in both the complexity and associated health care expenditures. These critically ill patients also experience substantial morbidity, including non-recovery of kidney function, dialysis dependence, and excessive mortality.

Problem to be addressed:
The optimal timing of RRT initiation in critically ill patients with AKI remains unknown. Moreover, there is no broad consensus to guide clinical practice on this issue and clinical studies have repeatedly highlighted the wide variability in the timing of RRT initiation in this population. Accordingly, there is a critical knowledge gap in evidence on the ideal timing of initiation of acute RRT in critically ill patients with AKI. The contradictory observations from existing data would strongly imply genuine equipoise for the acquisition of higher quality evidence on this issue.

Principle Research Question of Program:
The over-arching question this research program proposes to answer is: Does accelerated (or early) initiation of RRT in critically ill patients with AKI reduce 90-day all-cause mortality and non-recovery of kidney function?

Status:
We have recently completed a multi-centre pilot trial that has successfully established the feasibility of performing a large international definitive trial. We are now initiating centers for this phase of the trial (ClinicalTrials.gov Identifier: NCT02568722)

Participating Centers

Across Canada, United States, Europe and Australia and New Zealand.