Early versus Delayed Initiation of Renal Replacement Therapy in Critically Ill Patients with Acute Kidney Injury: A Systematic Review and Meta-Analysis of Randomized Trials
Systematic review and meta-analysis finds no mortality benefit of early renal replacement therapy in AKI patients, suggesting a delayed approach may be safer.
Key Points
Early initiation of renal replacement therapy does not reduce mortality in critically ill patients with acute kidney injury.
Analysis of 19 randomized controlled trials showed no survival benefit, including for those under or over age 65.
Subgroup analyses based on illness severity also revealed no significant differences in mortality outcomes.
Early renal replacement therapy was linked to a higher risk of infection compared to delayed initiation.