Finally, based on the data from the pilot study and regulatory input, the definition of persistent renal impairment was changed from an increase in the serum creatinine degree of 0.3 mg per deciliter or even more from baseline to discharge or time 7 to an increase at both day 7 and time 14. The neutral outcomes of PROTECT primarily reflect this insufficient a favorable effect on the serum creatinine level. Perhaps the probably explanation for the differences between your findings in the two studies is the large uncertainty approximately the results of the pilot study because of the small treatment groups and the dependence on these findings in designing critical elements of the main trial, like the selection of a single dose, entry criteria, and end points.11 The post hoc collection of the very best of three dose groups from a pilot trial with multiple small treatment groups carries the inherent risk an apparent superiority may be the enjoy of chance and that these findings may not be replicable in a far more definitive, bigger study, as occurred in today’s trial.Study co-authors include Ron Wald, MDCM, Chaim M. Bell, MD, PhD, FRCPC ; Marcello Tonelli, MD , Brenda R. Hemmelgarn, MD, PhD, FRCPC ; and Sushrut S. Waikar, MD . In reviewing the outcomes of Dr. James’ and Dr. Chertow’s study within an accompanying editorial, William McClellan, MD stated that the analysis was well-designed and that its outcomes should encourage investigators to recognize ‘potentially modifiable risk factors that donate to mortality differences’ so that efforts can be made to reduce AKI patients’ risk of dying when admitted to a healthcare facility on a weekend. He noted that current guidelines recommend that a patient who’s admitted to the hospital for AKI should get a timely consultation with a kidney professional, a determination of the severe nature and cause of their condition, appropriate medications and dietary support, and various other attributes of treatment.