Selection and Receipt of Kidney Replacement in Critically Ill Older Patients with Acute Kidney Injury (OPTIMAL-AKI)
Sean Bagshaw, Ron Wald
Main publication: OPTIMAL-AKI (main cohort)
Most older, critically ill patients with severe AKI were perceived as candidates for kidney replacement therapy, and approximately one half received therapy. Both willingness to offer kidney replacement therapy and reasons for not starting showed heterogeneity due to a range in patient-specific factors and clinician perceptions of benefit.
Secondary publication: OPTIMAL-AKI (frailty)
Pre-existing frailty is an independent risk factor for mortality among older critically ill patients with severe AKI. A substantial proportion of survivors experience declining function and worsened frailty status within one year.
OPTIMAL-AKI is part of the STARRT-AKI (STandard versus Accelerated initiation of Renal Replacement Therapy in Acute Kidney Injury) program of research.
University of Alberta Hospital, Edmonton: Sean M Bagshaw, Nadia Baig; Sunnybrook Health Sciences Centre, Toronto: Neill KJ Adhikari, Nicole Marinoff, Adic Perez; St. Michael’s Hospital, Toronto: Karen Burns, Jan Friedrich, Julia Lee, Yoon Lee, Kurtis Salway, Gyan Sandhu, Orla Smith, Ron Wald, Melissa Wang; Hôpital du Sacré-Coeur de Montréal, Montreal: Josée Bouchard, Anatolie Duca; Centre de recherche du hospitalier universitaire de Sherbrooke (CHUS), Sherbrooke: Francois Lamontagne, Patrick Bérubé, Hélène Fournier; Ottawa Hospital, Ottawa: Lauralyn McIntrye, Irene Watpool, Rebecca Porteus, Brigette Gomes; Centre hospitalier universitaire de Montréal (CHUM), Montreal: Jean-François Cailhier, Fatna Benettaib; St. Paul’s Hospital, Vancouver: Peter Dodek, Betty Jean Ashley, Victoria Alcuaz; Foothills Medical Centre, Calgary: Henry T. Stelfox, Stacey Ruddell; Toronto General Hospital, University Health Network, Toronto: Margaret Herridge, Andrea Matte; Mount Sinai Hospital, University Health Network, Toronto: Stephen Lapinsky, Sumesh Shah; Kingston General Hospital, Kingston: John Muscedere, Miranda Hunt, Ilinca Georgescu; St. Paul’s Hospital, Saskatoon: James Barton, Dorota Polewicz; Vancouver General Hospital, Vancouver: Donald Griesdale, Denise Foster; St. Joseph’s Hospital, Hamilton: Mark Soth, Kristine Wachmann
Sean M Bagshaw*, Ron Wald*, Neill KJ Adhikari, Karen EA Burns, Jan O Friedrich, Josée Bouchard, Francois Lamontagne, Lauralyn A. McIntrye, Jean-François Cailhier, Peter Dodek, Henry T. Stelfox, Margaret Herridge, Stephen Lapinsky, John Muscedere, James Barton, Donald Griesdale, Mark Soth, Althea Ambosta, Gerald Lebovic *co-PI