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Review
. 2020 May 10;9(5):1413.
doi: 10.3390/jcm9051413.

Timing of Initiation of Renal Replacement Therapy in Sepsis-Associated Acute Kidney Injury

José Agapito Fonseca  1 , Joana Gameiro  1 , Filipe Marques  1 , José António Lopes  1
Affiliations
Review

Timing of Initiation of Renal Replacement Therapy in Sepsis-Associated Acute Kidney Injury

José Agapito Fonseca et al. J Clin Med. .

Abstract

Sepsis-associated acute kidney injury (SA-AKI) is a major issue in medical, surgical and intensive care settings and is an independent risk factor for increased mortality, as well as hospital length of stay and cost. SA-AKI encompasses a proper pathophysiology where renal and systemic inflammation play an essential role, surpassing the classic concept of acute tubular necrosis. No specific treatment has been defined yet, and renal replacement therapy (RRT) remains the cornerstone supportive therapy for the most severe cases. The timing to start RRT, however, remains controversial, with early and late strategies providing conflicting results. This article provides a comprehensive review on the available evidence on the timing to start RRT in patients with SA-AKI.

Keywords: acute kidney injury; prevention; renal replacement therapy; sepsis; treatment.

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Conflict of interest statement

The authors declare no conflicts of interest.

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