We thank Dreyfuss et al1 for their valuable perspective. Inevitably, the contemporaneous release of the AKIKI (Artificial Kidney Initiation in Kidney Injury) and ELAIN (Effect of Early vs Delayed Initiation of Renal Replacement Therapy on Mortality in Critically Ill Patients With Acute Kidney Injury) trials and their major contributions to the field have made the 2 trials subjects for comparison.2,3 In our commentary, we sought to review how these trials advance our understanding while highlighting the important differences between the 2 studies.