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Critical Care
Published in: Critical Care 1/2021

Open Access 01-12-2021 | Acute Kidney Injury | Commentary

When should we start renal-replacement therapy in critically ill patients with acute kidney injury: do we finally have the answer?

Authors: Sean M. Bagshaw, Eric A. Hoste, Ron Wald

Published in: Critical Care | Issue 1/2021

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Excerpt

A significant proportion of critically ill patients with severe AKI, particularly those who develop refractory complications [1], receive support with renal-replacement therapy (RRT) [2]. There has been a longstanding dilemma on when RRT should be started for patients with severe AKI, specifically among those without AKI-related complications that could be addressed by RRT. Among patients with urgent or refractory complications, there is consensus for starting RRT. However, should RRT be started earlier in the course of AKI to pre-empt complications or judiciously delayed and started if and when complications arise? Furthermore, clinicians are challenged to select those patients who will have high probability of clinical benefit (restore metabolic/fluid homeostasis) and improved outcome (survival, recovery, quality of life) and to avoid RRT in patients who do not need it, will not benefit from it or who have greater probability of experiencing harm from it. …
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Metadata
Title
When should we start renal-replacement therapy in critically ill patients with acute kidney injury: do we finally have the answer?
Authors
Sean M. Bagshaw
Eric A. Hoste
Ron Wald
Publication date
01-12-2021
Publisher
BioMed Central
Published in
Critical Care / Issue 1/2021
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/s13054-021-03600-x

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