This is trial that tries to rewrite the rules of nephrology trials by moving the research out of the hands of a few academic centers and put it the hands of individual nephrologists.
In this case the subject is the timing of dialysis in AKI. A distributed network of nephrologists would rapidly randomize 2,000 AKI ICU patients to either early dialysis or usual care.
The primary endpoint is mortality at 90 days in patients with AKI in the intensive care unit (ICU). Kidney function recovery is a secondary endpoint.