Target trial emulation reveals early renal replacement therapy can lower mortality in severe acute kidney injury, suggesting tailored approaches are vital.
Key Points
Early initiation of renal replacement therapy lowers 90-day mortality in severe acute kidney injury patients, but risks exist in broader cohorts.
In the broader cohort, early treatment associated with a hazard ratio of 0.653 for 90-day mortality, indicating potential risks.
Target trial emulation using MIMIC-IV database provided robust causal estimates through Cox models and inverse probability weighting.
Personalized treatment approaches are necessary to optimize renal replacement therapy timing based on acute kidney injury severity.