Original Investigation

Cost-Utility Analysis of Accelerated and Standard Strategies for Renal Replacement Therapy Initiation

JAMA Network Open 10.1001/jamanetworkopen.2025.35343

October 03, 2025 at 11:00 AM EDT

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Is accelerated initiation of kidney replacement therapy cost-effective compared with standard initiation in critically ill patients with acute kidney injury?This economic evaluation of 146 patients found that standard initiation of kidney replacement therapy is cost-effective compared with accelerated initiation, with an incremental cost-effectiveness ratio of $22 648 per quality-adjusted life-year (costs measured in 2024 Canadian dollars).These findings suggest that standard initiation of kidney replacement therapy is a cost-effective use of health care resources when compared with accelerated initiation.

Corresponding Author: Jeff Round, PhD, Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, 11405 87th Ave NW, Edmonton, T6G 1C9 AB, Canada (jround@ualberta.ca).

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