We disagree with the comparison between the AKIKI (Artificial Kidney Initiation in Kidney Injury) trial1 and the ELAIN (Effect of Early vs Delayed Initiation of Renal Replacement Therapy on Mortality in Critically Ill Patients With Acute Kidney Injury) trial2 in the recent editorial by Wald et al.3 The ELAIN trial had several weaknesses in that it was single centered, included mainly post–cardiac surgery patients, and involved very early (Kidney Disease: Improving Global Outcomes class 2) renal replacement therapy (RRT) initiation.