Abstract:

ABSTRACT Despite advances in clinical practice and renal replacement therapy (RRT), the mortality in patients with acute kidney injury remains high. To date many RRT-related issues are still controversial, including RRT modality, dose and initiation time. In regard of time, whether early initiation of RRT benefits outcome is the key issue. However, there is even absent of generally accepted definition of early initiation; furthermore, the major data on this issue is primarily centered on retrospective observational reports with small sample size and great heterogeneity for etiology of acute kidney injury and patients’ comorbidity. Evidence from so far limited numbers of prospective studies (although with small sample size) showed no any significant advantage for an “early” start approach. As such until adequately powered prospective trial data become available, when to initiate RRT should be decided based on taking into account disease history, full clinical assessments, biochemical tests results, as well as the cost and risk of RRT.

Key words: acute kidney injury, renal replacement therapy, complication