Timing of initiation of renal replacement therapy for acute kidney injury

Abstract

Acute kidney injury (AKI) is one of the most common organ dysfunction in critically ill patients, with high morbidity and mortality. Renal replacement therapy (RRT) remains the cornerstone in the treatment of severe AKI. Multiple clinical studies with regards to optimal timing of initiation of RRT showed mixed results despite the perception that timely initiation of RRT might improve clinical outcome in patients with AKI, with inconsistent definition of early versus late initiation of RRT in different clinical studies. In clinical practice, the decision to initiate RRT should be individualized with the consideration of clinical context. Biomarker-based strategy of initiation of RRT still merits validation of further clinical studies. Key words: Acute kidney injury; Renal replacement therapy; Timing of initiation