{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T17:30:05Z","timestamp":1787160605328,"version":"build-2736575974"},"reference-count":36,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2015,2,24]],"date-time":"2015-02-24T00:00:00Z","timestamp":1424736000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Venerable Yen-Pei National Kidney Foundation Research Fund","award":["NKFRC\/2011\/07\/24"],"award-info":[{"award-number":["NKFRC\/2011\/07\/24"]}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nephrology"],"published-print":{"date-parts":[[2015,3]]},"abstract":"Abstract<\/jats:title>\n \n Aim<\/jats:title>\n \n Optimal timing for acute renal replacement therapy (\n ARRT<\/jats:styled-content>\n ) initiation in critically ill patients with acute kidney injury (\n AKI<\/jats:styled-content>\n ) is unclear. We aimed to evaluate outcomes in patients who initiated\n ARRT<\/jats:styled-content>\n for traditional indications\n versus<\/jats:italic>\n those who met\n A<\/jats:styled-content>\n cute\n K<\/jats:styled-content>\n idney\n I<\/jats:styled-content>\n njury\n N<\/jats:styled-content>\n etwork (\n AKIN<\/jats:styled-content>\n ) criteria without traditional indications.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n This was a single\u2010centre prospective cohort study of medical and surgical intensive care patients with\n AKI<\/jats:styled-content>\n . Traditional indications for\n ARRT<\/jats:styled-content>\n initiation included: serum potassium \u22656.0\u2009mmol\/L, serum urea \u226530\u2009mmol\/L, arterial\n pH<\/jats:styled-content>\n \u2009<\u20097.25, serum bicarbonate <10\u2009mmol\/L, acute pulmonary oedema, acute uraemic encephalopathy or pericarditis. In absence of these indications,\n ARRT<\/jats:styled-content>\n was commenced if patients had (i)\n AKIN<\/jats:styled-content>\n Stage 3 or (ii)\n AKIN<\/jats:styled-content>\n Stage 1 or 2 with \u2018compelling\u2019 conditions. Primary outcomes were intensive care unit (\n ICU<\/jats:styled-content>\n ) and in\u2010hospital mortality.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n ARRT<\/jats:styled-content>\n was initiated in 140 patients: traditional indications in 56 (40%);\n AKIN S<\/jats:styled-content>\n tage 3 without traditional indications in 38 (27%); and\n AKIN<\/jats:styled-content>\n Stage 1 or 2 with \u2018compelling\u2019 conditions in 46 (33%) patients. Traditional indications at\n ARRT<\/jats:styled-content>\n initiation was associated with increased in\u2010hospital mortality (adjusted odds ratio (95% confidence interval), 6.48 (1.54, 27.29)). In absence of traditional indications, earlier\n ARRT<\/jats:styled-content>\n initiation, as defined by those with\n AKIN<\/jats:styled-content>\n Stage 1 or 2, did not decrease\n ICU<\/jats:styled-content>\n deaths (30.0%\n vs<\/jats:italic>\n 18.8%,\n P<\/jats:italic>\n \u2009=\u20090.30) or in\u2010hospital mortality (50.0%\n vs<\/jats:italic>\n 34.2%,\n P<\/jats:italic>\n \u2009=\u20090.15) compared with those who were started on\n ARRT<\/jats:styled-content>\n for\n AKIN<\/jats:styled-content>\n Stage 3.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Presence of traditional indications at\n ARRT<\/jats:styled-content>\n initiation was associated with greater mortality. Initiating dialysis at earlier\n AKIN<\/jats:styled-content>\n stage did not improve survival in patients without traditional indications.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/nep.12364","type":"journal-article","created":{"date-parts":[[2014,11,13]],"date-time":"2014-11-13T22:14:26Z","timestamp":1415916866000},"page":"148-154","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Initiating acute dialysis at earlier\n A<\/scp>\n cute\n K<\/scp>\n idney\n I<\/scp>\n njury\n N<\/scp>\n etwork stage in critically ill patients without traditional indications does not improve outcome: A prospective cohort study"],"prefix":"10.1111","volume":"20","author":[{"given":"Cynthia Ciwei","family":"Lim","sequence":"first","affiliation":[{"name":"Department of Renal Medicine Singapore General Hospital Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chieh Suai","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Renal Medicine Singapore General Hospital Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manish","family":"Kaushik","sequence":"additional","affiliation":[{"name":"Department of Renal Medicine Singapore General Hospital Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Han Khim","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Renal Medicine Singapore General Hospital Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,2,24]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2004090740"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-200209000-00016"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-001-1159-4"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2013.02.349"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0802639"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0902413"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.04871107"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfi296"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.00450206"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.03830907"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/cc8037"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.01430406"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2007.12.017"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2008.02.371"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/cc10061"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.3109\/0886022X.2011.589945"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2004.00433.x"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/cc7123"},{"key":"e_1_2_6_20_1","first-page":"S1","article-title":"K\/DOQI clinical practice guidelines for chronic kidney disease: Evaluation, classification, and stratification","volume":"39","author":"National Kidney Foundation","year":"2002","journal-title":"Am. 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