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Crit Care. 2017 Jun 20;21(1):146. doi: 10.1186/s13054-017-1713-2.

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

Author information

1
Division of Nephrology, Department of Internal Medicine, Saint Mary's Hospital Luodong, No. 160 Chong-Cheng South Road, Loudong 265, Yilan, Taiwan (Republic of China).
2
Saint Mary's Junior College of Medicine, Nursing and Management, No.100, Ln. 265, Sec. 2, Sanxing Road, Sanxing Township, Yilan County, 266, Taiwan (Republic of China).
3
Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, No. 7 Chung-Shan South Road, Zhong-Zheng District, Taipei, 100, Taiwan (Republic of China).
4
ICU Department, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, 101, Laarbeeklaan, 1090 Jette, Brussels, Belgium. herbert.spapen@uzbrussel.be.
5
ICU Department, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, 101, Laarbeeklaan, 1090 Jette, Brussels, Belgium. Patrick.Honore@az.vub.ac.be.
6
Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, No. 7 Chung-Shan South Road, Zhong-Zheng District, Taipei, 100, Taiwan (Republic of China). q91421028@ntu.edu.tw.
7
NSARF, National Taiwan University Study Group on Acute Renal Failure, Taipei, Taiwan (Republic of China). q91421028@ntu.edu.tw.

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.

KEYWORDS:

Acute kidney injury; Delayed; Early; Intensive care unit; Renal replacement therapy; Timing

PMID:
28629397
PMCID:
PMC5477147
DOI:
10.1186/s13054-017-1713-2
[Indexed for MEDLINE]
Free PMC Article

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