Critical Care (Jun 2017)

Optimal timing of renal replacement therapy initiation in acute kidney injury: the elephant felt by the blindmen?

  • Chih-Chung Shiao,
  • Tao-Min Huang,
  • Herbert D. Spapen,
  • Patrick M. Honore,
  • Vin-Cent Wu

DOI
https://doi.org/10.1186/s13054-017-1713-2
Journal volume & issue
Vol. 21, no. 1
pp. 1 – 7

Abstract

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Abstract Renal replacement therapy (RRT) is a key component in the management of severe acute kidney injury (AKI) in critically ill patients. Many cohort studies, meta-analyses, and two recent large randomized prospective trials which evaluated the relationship between the timing of RRT initiation and patient outcome remain inconclusive due to substantial differences in study design, patient population, AKI definition, and RRT indication. A cause-specific diagnosis of AKI based on current staging criteria plus a sensitive biomarker (panel) that allows creating a homogeneous study population is definitely needed to assess the impact of early versus late initiation of RRT on patient outcome.

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