Accelerated RRT initiation (experimental arm): A dialysis catheter will be placed and RRT initiated as soon as possible and no more than 12 hours after the patient became fully eligible.
Standard RRT initiation (control arm): In the absence of kidney function recovery, the initiation of RRT will be permitted if one of the following develops:
1) serum potassium ≥ 6.0 mmol/L;
2) pH ≤ 7.20 or serum bicarbonate ≤ 12 mmol/L;
3) severe respiratory failure, based on a PaO2/FiO2 ≤ 200 and clinical perception of volume overload;
4) and/or persistent AKI > 72 hours following the time of randomization.
Once a decision is made to start RRT, a dialysis catheter will be placed and RRT initiated as soon as possible. All other aspects of RRT (i.e., RRT modality, CRRT mode (if applicable), dose-intensity, anticoagulation) administered to patients in both arms will follow current best practice and local standards of care.