Renal Failure (Dec 2025)

Kidney replacement therapy during extracorporeal membrane oxygenation: pathophysiology, technical considerations, and outcomes

  • Michele Petrova Xin Ling Lau,
  • Ryan Ruiyang Ling,
  • Brandon Jin An Ong,
  • Hwa Jin Cho,
  • In-seok Jeong,
  • Tapas Kumar Sahoo,
  • Horng Ruey Chua,
  • Kiran Shekar,
  • Kollengode Ramanathan

DOI
https://doi.org/10.1080/0886022x.2025.2486557
Journal volume & issue
Vol. 47, no. 1

Abstract

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The use of extracorporeal membrane oxygenation has been increasing over time, in part due to the COVID-19 pandemic. Whilst lifesaving, complications that must be managed are also associated with its use. AKI and fluid overload are complications of concern due to their associations with poor outcomes, and ability to be managed by additional interventions such as the use of kidney replacement therapy. Various modalities, timings, and types of kidney replacement therapy are currently being used and outcomes regarding its concurrent use with extracorporeal membranous oxygenation across centers may be mixed. In this review, we discuss the pathophysiology of AKI, methods, modalities and impact of concurrent extracorporeal membrane oxygenation and kidney replacement therapy.

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