Nephrology has been the recent beneficiary of a handful of studies examining the impact of the timing of the initiation of dialysis in AKI. One of these trials, AKIKI, now has a genuine sequel. In 2016 AKIKI was the first multi-center RCT examining early initiation of dialysis versus late initiation of dialysis and showed that early initiation not only did not improve patient outcomes but resulted in a significant number of patients receiving dialysis that would have recovered kidney function without intervention had they only been randomized to the late arm. Now five years later we are reviewing the sequel which asks the next logical question, “If delayed dialysis is as good as early dialysis is even later dialysis equivalent or better?”
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