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June 20, 2026BMC NephrologyOpen Access

Timing of renal-replacement therapy in patients with acute kidney injury and sepsis: a systematic review and meta-analysis

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Authors

ZSZaid Bin SahaqSASaud Mohammed Ali AlotaibiMAMd. Mokshead Ali

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Overview

Systematic review compares early and delayed renal replacement therapy impacts on mortality in sepsis-associated acute kidney injury patients, suggesting needs for tailored approaches.

Key Points

  • This review aims to evaluate the effects of early versus delayed renal replacement therapy initiation in patients with sepsis-associated acute kidney injury.
  • Conducted a systematic review and meta-analysis of studies from PubMed, Scopus, Web of Science, and Cochrane CENTRAL up to February 2026.
  • Included randomized controlled trials and observational cohorts comparing early versus delayed RRT in sepsis-associated AKI patients.
  • Pooled data using random-effects models to assess various outcome measures.
  • Early RRT reduced 28-day mortality compared to delayed initiation (RR 0.81, 95% CI: 0.68–0.95, p = 0.01).
  • No significant differences in 90-day mortality (RR 0.85, 95% CI: 0.69–1.04, p = 0.12) or multi-organ dysfunction score (MD 0.24, 95% CI: -0.94–1.42, p = 0.69).
  • Early RRT did not improve ICU or hospital length of stay significantly (ICU: MD -1.76, 95% CI: -4.18–0.66, p = 0.15; Hospital: MD 0.34, 95% CI: -3.24–3.92, p = 0.85).

Cite This Study

Sahaq et al. (2026) studied this question.

synapsesocial.com/papers/6a362e91db0793dc1a53641bhttps://doi.org/10.1186/s12882-026-05132-4
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Early versus Delayed Initiation of Renal Replacement Therapy in Critically Ill Patients with Acute Kidney Injury: A Systematic Review and Meta-Analysis of Randomized Trials2025
  2. 2Impact of Early Initiation of Renal Replacement Therapy on Renal Recovery and Mortality in Critically Ill Patients with Acute Kidney Injury: A Prospective Cohort Study2025 · 3 citations
  3. 3The early bird in renal rescue: timing matters in acute kidney injury management—insights from target trial emulation2025
  4. 4Evaluation of Outcomes After Early Versus Late Initiation of Continuous Renal Replacement Therapy in Adult Patients With Sepsis-Associated Acute Kidney Injury2026
  5. 5Impact of Early Initiation of Antimicrobials on Acute Kidney Injury Due to Sepsis2025