Optimising the timing of renal replacement therapy in acute kidney injury
- PMID: 34059096
- PMCID: PMC8165519
- DOI: 10.1186/s13054-021-03614-5
Optimising the timing of renal replacement therapy in acute kidney injury
Abstract
The optimal timing of renal replacement therapy (RRT) in critically ill patients with acute kidney injury (AKI) has been much debated. Over the past five years several studies have provided new guidance for evidence-based decision-making. High-quality evidence now supports an approach of expectant management in critically ill patients with AKI, where RRT may be deferred up to 72 h unless a life-threatening indication develops. Nevertheless, physicians' judgment still plays a central role in identifying appropriate patients for expectant management.
Keywords: Acute kidney injury; Continuous renal replacement therapy; Intensive care.
Conflict of interest statement
JAK was a co-author of the ELAIN study.
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References
-
- Karvellas CJ, Farhat MR, Sajjad I, Mogensen SS, Leung AA, Wald R, et al. A comparison of early versus late initiation of renal replacement therapy in critically ill patients with acute kidney injury: a systematic review and meta-analysis. Crit Care. 2011;15:R72. doi: 10.1186/cc10061. - DOI - PMC - PubMed
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