Please select the eligibility criteria that correspond to the clinical trial below.
Title: STandard Versus Accelerated Initiation of Renal Replacement Therapy in Acute Kidney Injury (STARRT-AKI): A Multi-Centre, Randomized, Controlled Trial (Principal Trial)
Brief Summary: The objectives of this trial are to determine whether, in critically ill patients with severe acute kidney injury (AKI), randomization to accelerated initiation of renal replacement therapy (RRT), compared to standard initiation, leads to:

1. Improved survival (primary outcome); and
2. Recovery of kidney function (principal secondary outcome), defined as independence from RRT at 90 days


Options:
A: Inclusion criteria The following five criteria are required for inclusion

1. Hospitalized in intensive care unit
2. Age ≥ 18 years
3. Acute kidney injury compatible with the diagnosis of acute tubular necrosis defined by a clinical ischemic or toxic insult context
4. Have an AKI classified as RIFLE F, that is to say, with at least one of the following three criteria:

   * creatinine\> 354 mmol / l or \> 3 times the baseline creatinine
   * anuria for more than 12 hours
   * oliguria defined as urine output \< 0.3 ml / kg / h or \< 500ml/d for more than 24 hours
5. Mechanical ventilation and/or catecholamines infusion (noradrenaline or/and adrenaline)

Non-inclusion criteria

One or more of the following criteria:

* Chronic renal failure (defined as creatinine clearance \< 30 ml / min)
* Patients already enrolled in the study
* Inclusion criteria number 4 present for more than 5 hours
* Acute renal failure due to:

  * urinary tract obstruction
  * renal vessels obstruction
  * tumor lysis syndrome
  * thrombotic microangiopathy
  * acute glomerulonephritis
* Intoxication with a dialyzable product
* Child-Pugh class C liver cirrhosis
* Renal transplant
* Cardiac arrest without awakening at time of potential inclusion
* Moribund state
* Decision to limit treatment
* RRT already started for the current episode of AKI
* Presenting (at the time of potential inclusion) a strong indication for immediate RRT

  * oligoanuria for more than 3 days
  * serum urea concentration \> 40 mmol / l serum potassium concentration \> 6 mmol /L, serum potassium concentration \> 5.5 mmol /L that persists despite well-conducted medical treatment with at least sodium bicarbonate and / or glucose-insulin infusion, arterial pH \< 7.15 in the context of pure metabolic acidosis (PaCO2 \<35 mmHg) or in the context of mixed acidosis with PaCO2\> 50 mmHg without possibility of lowering this PaCO2 value, acute overload pulmonary edema generating severe hypoxemia requiring oxygen flow\> 5L/min in spontaneously breathing patients or FiO2\> 50% in mechanically (invasive or noninvasive) ventilated to maintain SpO2\> 95%, despite diuretic therapy.
* Under cardiopulmonary bypass
* Included in another clinical trial on RRT modalities.
B: Inclusion Criteria:

1. Age ≥ 18 years
2. Admission to an intensive care unit (ICU)
3. Evidence of kidney dysfunction \[serum creatinine ≥100 µmol/L (women) and ≥ 130 µmol/L (men)\]
4. Evidence of severe AKI defined by at least 1 of the following 3 criteria:

   i) ≥ 2-fold increase in serum creatinine from a known pre-morbid baseline or during the current hospitalization; OR ii) Achievement of a serum creatinine ≥ 354 µmol/L with evidence of a minimum increase of 27 µmol/L from pre-morbid baseline or during the current hospitalization; OR iii) Urine output \< 6.0 mL/kg over the preceding 12 hours

Exclusion Criteria:

1. Serum potassium \> 5.5 mmol/L
2. Serum bicarbonate \< 15 mmol/L
3. Presence of a drug overdose that necessitates initiation of RRT
4. Lack of commitment to ongoing life support (including RRT)
5. Any RRT within the previous 2 months (either acute or chronic RRT)
6. Kidney transplant within the past 365 days
7. Known pre-hospitalization advanced chronic kidney disease, defined by an estimated glomerular filtration rate \< 20 mL/min/1.73 m2
8. Presence or clinical suspicion of renal obstruction, rapidly progressive glomerulonephritis, vasculitis, thrombotic microangiopathy or acute interstitial nephritis
9. Clinician(s) caring for patient believe(s) that immediate RRT is mandated
10. Clinician(s) caring for patient believe(s) that deferral of RRT initiation is mandated

    * at their discretion, clinicians may administer a bolus of intravenous furosemide (ie, "furosemide stress test") and evaluate the subsequent urine output to help guide decision making regarding the likelihood of AKI progression
C: Inclusion Criteria:

* Patients 18 years or older
* Written informed consent
* No pre-existing dialysis dependency

Exclusion Criteria:

* Minors / children
* No consent
* Severe electrolyte disturbances which necessitates special dialysis therapy
D: Inclusion criteria

1. Age between 18 and 90 years.
2. Patients admitted into ICU with Sepsis (sepsis-3) compatible with the diagnosis of AKI at stage 2 of KDIGO classification.
3. Informed consent provided by the patient or person with decisional responsibility.

Exclusion criteria

1. Presence of one of the emergent CRRT conditions before randomization:

1. Hyperkalemia \> 6.0 mmol/L or \> 5.5 mmol/L persisting despite medical treatment.
2. Acute pulmonary edema due to fluid overload responsible for severe hypoxemia requiring oxygen flow rate \> 5 L/min to maintain a percutaneous oxygen saturation (SpO2) \> 95% or a fraction of inspiration oxygen (FiO2) \> 50% in patients already on invasive or non-invasive mechanical ventilation and despite diuretic therapy.
3. Blood urea nitrogen (BUN) \> 112 mg/dl (40 mmol/L). 2. Pre-existing severe chronic renal failure \[estimated glomerular filtration rate (eGFR) \< 30 ml/min\].

3. Previous renal replacement therapy. 4. Prior kidney t

Answer: B