Early intervention with erythropoietin does not affect the outcome of acute kidney injury (the EARLYARF trial)

摘要: We performed a double-blind placebo-controlled trial to study whether early treatment with erythropoietin could prevent the development of acute kidney injury in patients two general intensive care units. As guide for choosing we measured urinary levels biomarkers, proximal tubular brush border enzymes γ-glutamyl transpeptidase and alkaline phosphatase. Randomization either placebo or doses was triggered by an increase biomarker concentration product above 46.3, primary outcome relative average plasma creatinine from baseline over 4 7 days. Of 529 patients, 162 were randomized within 3.5 h positive sample. There no difference incidence erythropoietin-specific adverse events between groups. The triggering selected more severe illness at greater risk injury, dialysis, death; however, marker elevations transient. Early intervention high-dose safe but did not alter outcome. Although these urine biomarkers facilitated our intervention, their transient compromised effective triaging. Further, showed that composite insufficient stratification patient population heterogeneous onset injury.