biostudies-literatureUnknown8(10)Round J<h4>Importance</h4>Little is known about the long-term costs and outcomes related to strategies for timing of initiation of kidney replacement therapy (KRT) in critically ill patients with severe acute kidney injury (AKI).<h4>Objective</h4>To estimate the cost-utility and cost-effectiveness of accelerated KRT initiation compared with standard KRT initiation in critically ill patients with AKI.<h4>Design, setting, and participants</h4>In this economic evaluation, a state-transition model was developed using data from the Standard vs Accelerated Initiation of Renal Replacement Therapy in AKI (STARRT-AKI) trial, a multicenter, multinational randomized clinical trial of critically ill patients with severe AKI conducted between October 2015 and September 2019. Trial data were linked to administJAMA network opene2535343https://www.ebi.ac.uk/biostudies/studies/S-EPMC12495491biostudies-literatureCost-Utility Analysis of Accelerated and Standard Strategies for Renal Replacement Therapy Initiation.PMC12495491Laurie GHasslacher JHashemighouchani HKeet ODitlbacher ADelabranche XSutinen SFletcher JHoppu SHiremath SGrainger LNieszkowska ASedillot NRussell MBoumahni DBailey MMartins LDrover JNay MAHoward KSantos MAttwood BWhite PBaudry TPolychronopoulos ESuen GQi ZD'Aragon FClarey ERicard JDWun JZuber BTowns MYu ZMcGonigal EHoughton JMonnier AVaara STCowdrey KAPeck LWald RRamsey JJudd HBradford CDilawershah MQi GMuller LVander Hayden KDong XWalczak Kvan Katwyk SDong LOrford NChen ZBurke TChen YRao JMurray Lvan Diepen SReece-Anthony RLafrance JPRomanovsky ASDecalvele MOrdon MAMcKerrow ENoble HChen MCombes AWillox FWagner MJarvisalo MJDominy CBenzekri DDos Santos SLowrey JMooney OAdda MPouplet CMuller GNichol ADVinsonneau CBrodutch SVarila SAndreu 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XBroadfield EEraldi JPYan CDiehl JLMaguire TVerlay MHarmon JLicari EBarchard JMasters KParsons PBenton JBihorac AZeng QBrickell KGutierrez DRaithatha AMalila KSejourne CCarson JLacherade JCDe Watteville ABellomo RHe XLin JGuitton CMew LHutch DGeorge APretorius RKullmar MRoy IFan JRobine AMargarson MGoundry SGhosh AMarinoff NWyncoll DNiven DJDelisle-Thibault CBarbar SDRozec BVinatier IGray GMallaird SALellouche FWootten ACamporota LPeters CMehta NHodder JQiu HDemiri SSalva JQiu YHill DKnott CHunt AMehta SHill HHunt MLi HFarrah HLi JShuker KMeyer JDe Prost NLi RLi MLi NSTARRT-AKI InvestigatorsCour MAllam HCahill HGuy ZTozzi MThevenin DVenz EMorris AKashani KBJalkanen VRyan LWallace SThevenin FDelecolle LJackson CScott TJackson DSaid SMarque SNeyra JAForni LGHambrook GAbrams JRosenberg ABuhr HHauschild CKutsogiannis DJCallhan JCAycinena JCGlybina AAltarelli MCollins AFriedrich JHartig FThompson PBurns KSmith OMGomez RWren LThompson TThiery GChadbourn IDevereaux KZhang JClark MZhang MShelley BZhang LMarchalot AClark AZhang SCarbonnaeu EClark EButler SFrancouer CLRichard RKerr DButler MBracke SJin XOstermann MBeck JWelters ICantien MKaye CElias MPorwal SEfron PMathonnet ADiel NGhate THarris CLMcGuinness SHazelton TKuitunen AAzais MACarles MMcGain FMillen THopkins PSangla FRolls CKiley SPitts SSalerno TMacIntyre ETiller EAlbrett JFadel FHirst CCorcoran ERuppert MZhou QKapoor RDreyfuss DMatheson EZhou XBoulet EGiebel SGuery AKoottayi SCallender OHallion JMcGuinness SPTolwani AKaur NMcAuley DFBrown GWen MPerret AMcGloughlin SSun JYang JGarg ARoux DCommeureuc MFinkenstedt ATchenio XMusselwhite JLiu KDBrooks JYang EYang ZYang YRoux STamion FCampisi JDoran PLeBlanc GDelaney ALadouceur MMcCoshen LPaunovic BMu SRobinson HDuan MLian YSim MWilcox MELappi ESlack ASutherland SBReignier JRoshdy AFrench CWhitehouse TMorgan SMorgan RSabev ARobinson CFellows EJoseph GMorgan MBrown SRobinson FBuscher HMarios CLangsjo JChenaf SOvakim DJunge ANeils SMcArthur CWhitlock RPSkarzynski 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VInkinen OPettila LHuang YDargent AWax RNovellas NGKarlsson SO'Mara AQin BChimunda TWu JChadwick LSimon MMeredith MVeenith TLyas CWang CWang DWu Cvan Waegeningh TCarungcong JWang HHuang LMorawiec EWang JWang KEndre ZWang PWang QSridhar KWang XWang YDignam GPogreban TMorizot LMcGlone PNaeem SPark PDodek PLu KRobert ALu LPrasad BLambert BLong DWolverson AMcCall PFinney CBeehre NLeaver SDing LLong SRogers PLembo RPoli EDing RRound JDe La Salle SFreebairn REller PLapinsky SJim KRosenow NLizotte PCampbell TCampbell VMaslove DRokosh ESt-Arnaud CSuhonen THeinonen JDaniels ASharif SCampbell EQuenot JPHenry-Lagarrigue MFelix LFoulkes SfalseCost-Utility Analysis of Accelerated and Standard Strategies for Renal Replacement Therapy Initiation.<h4>Importance</h4>Little is known about the long-term costs and outcomes related to strategies for timing of initiation of kidney replacement therapy (KRT) in critically ill patients with severe acute kidney injury (AKI).<h4>Objective</h4>To estimate the cost-utility and cost-effectiveness of accelerated KRT initiation compared with standard KRT initiation in critically ill patients with AKI.<h4>Design, setting, and participants</h4>In this economic evaluation, a state-transition model was developed using data from the Standard vs Accelerated Initiation of Renal Replacement Therapy in AKI (STARRT-AKI) trial, a multicenter, multinational randomized clinical trial of critically ill patients with severe AKI conducted between October 2015 and September 2019. Trial data were linked to administ2025-01-01T00:00:00Z2025 Oct2026-06-04T02:39:54.935Z2026-05-04T03:13:57.97ZS-EPMC124954914104250810.1001/jamanetworkopen.2025.35343