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Timing of Kidney Support Therapy in Acute Kidney Injury: What Are We Waiting For?

American Journal of Kidney Diseases, ISSN: 0272-6386, Vol: 79, Issue: 3, Page: 417-426
2022
  • 18
    Citations
  • 0
    Usage
  • 72
    Captures
  • 3
    Mentions
  • 99
    Social Media
Metric Options:   Counts1 Year3 Year

Metrics Details

  • Citations
    18
  • Captures
    72
  • Mentions
    3
    • News Mentions
      2
      • News
        2
    • Blog Mentions
      1
      • Blog
        1
  • Social Media
    99
    • Shares, Likes & Comments
      99
      • Facebook
        99

Most Recent News

Differential effect on mortality of the timing of initiation of renal replacement therapy according to the criteria used to diagnose acute kidney injury: an IDEAL-ICU substudy

Abstract Background This substudy of the randomized IDEAL-ICU trial assessed whether the timing of renal replacement therapy (RRT) initiation has a differential effect on 90-day

Review Description

The optimal timing of kidney support therapy in critically ill patients with acute kidney injury (AKI) without life-threatening complications related to AKI is controversial. Recent multicenter, randomized, controlled studies have questioned the need for earlier initiation of therapy, despite one study showing a benefit in survival and others with no differences in mortality based on the timing of kidney support therapy initiation. These findings reflect the uncertainties in decisions to initiate kidney support therapy, which should ideally be individualized according to the patient’s comorbidities, severity of illness, trajectory of kidney function, and urine output as well as requirements for fluid balance and solute removal. A delayed approach could translate into a potentially reduced burden of dialysis dependence in addition to saving health resources. However, we must ascertain what constitutes the waiting period and the benefits and risks associated with this approach. This article reviews the concept of timing of dialysis in AKI, performs a critical assessment of the most important clinical trials in this topic, discusses ongoing research and knowledge gaps, and defines key research issues to address in the future.

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