Keywords
Critical Illness
Intensive Care Units
Renal Replacement Therapy
Mortality
How to Cite
Abstract
Acute kidney injury (AKI) is a common entity in critically ill patients. It can occur in 30% to 60% of patients in the intensive care unit (ICU), conferring a poor clinical prognosis. Many critically ill patients with AKI undergo renal replacement therapy (RRT), however, in the absence of absolute indications such as acute pulmonary edema refractory to diuretics and major metabolic disorders such as uremia, acidosis and severe hyperkalemia, the optimal timing for initiation of RRT to improve clinical outcomes remains uncertain and is still a matter of debate.
In recent years, multiple studies have focused on determining the ideal timing for initiation of RRT in the setting of the critically ill patient with AKI. Several observational studies and small randomized controlled trials suggest that early initiation of RRT may improve survival; however, more recent trials have found no statistically significant difference in mortality between an early and a late strategy for initiation of RRT in critically ill patients with severe AKI.
References
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