ArticleAmerican journal of respiratory and critical care medicine2019
Timing of Renal Replacement Therapy for Severe Acute Kidney Injury in Critically Ill Patients.
Article in American journal of respiratory and critical care medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
21 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Guidelines for Enhanced Recovery After Trauma and Intensive Care (ERATIC): Enhanced Recovery After Surgery (ERAS) and International Association for Trauma Surgery and Intensive Care (IATSIC) Society Recommendations: Paper 2: Postoperative and Intensive Care Recommendations.World journal of surgery · 2025Guideline
- Accelerated versus standard initiation of renal replacement therapy for critically ill patients with acute kidney injury: a systematic review and meta-analysis of RCT studies.Critical care (London, England) · 2021Pooled it
- Cost-Utility Analysis of Accelerated and Standard Strategies for Renal Replacement Therapy Initiation.JAMA network open · 2025Trial
- Averaged versus Persistent Reduction in Urine Output to Define Oliguria in Critically Ill Patients: An Observational Study.Clinical journal of the American Society of Nephrology : CJASN · 2024Article
- When to start renal replacement therapy in acute kidney injury: What are we waiting for?Journal of intensive medicine · 2024Review
- Personalizing renal replacement therapy initiation in the intensive care unit: a reinforcement learning-based strategy with external validation on the AKIKI randomized controlled trials.Journal of the American Medical Informatics Association : JAMIA · 2024Article
- Effects of cell-free DNA on kidney disease and intervention strategies.Frontiers in pharmacology · 2024Review
- The benefits of early continuous renal replacement therapy in critically ill patients with acute kidney injury at high-altitude areas: a retrospective multi-center cohort study.Scientific reports · 2023Article
- suPAR links a dysregulated immune response to tissue inflammation and sepsis-induced acute kidney injury.JCI insight · 2023Article
- Modelling kidney outcomes based on MELD eras - impact of MELD score in renal endpoints after liver transplantation.BMC nephrology · 2022Article
- Accelerated versus watchful waiting strategy of kidney replacement therapy for acute kidney injury: a systematic review and meta-analysis of randomized clinical trials.Clinical kidney journal · 2022Article
- Optimising the timing of renal replacement therapy in acute kidney injury.Critical care (London, England) · 2021Article
- Renal Replacement Therapy in Pregnancy-related Acute Kidney Injury: Getting the Timing Right.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2020Article
- PERSEVERE Biomarkers Predict Severe Acute Kidney Injury and Renal Recovery in Pediatric Septic Shock.American journal of respiratory and critical care medicine · 2020Observational
- Comparison between watchful waiting strategy and early initiation of renal replacement therapy in the critically ill acute kidney injury population: an updated systematic review and meta-analysis.Annals of intensive care · 2020Article
- The artificial kidney induces acute kidney injury: yes.Intensive care medicine · 2020Article
- An Inhibitor of DRP1 (Mdivi-1) Alleviates LPS-Induced Septic AKI by Inhibiting NLRP3 Inflammasome Activation.BioMed research international · 2020Article
- The Artificial Kidney Initiation in Kidney Injury 2 (AKIKI2): study protocol for a randomized controlled trial.Trials · 2019Article
- Delaying Renal Replacement Therapy Could Be Harmful in Patients with Acute Brain Injury.American journal of respiratory and critical care medicine · 2019Article
- Reply to ChoustermanAmerican journal of respiratory and critical care medicine · 2019Article
Corrections and comments
- Commented on by
- Commented on by
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Acute kidney injury (AKI) affects many ICU patients and is responsible for increased morbidity and mortality. Although lifesaving in many situations, renal replacement therapy (RRT) may be associated with complications, and the appropriate timing of its initiation is still the subject of intense debate. An early initiation strategy can prevent some metabolic complications, whereas a delayed one may allow for renal function recovery in some patients without need for this costly and potentially dangerous technique. For years, most of the knowledge on this issue stemmed from observational studies or small randomized controlled trials. Recent randomized controlled trials have indicated that a watchful waiting strategy (in the absence of life-threatening conditions such as severe hyperkalemia or pulmonary edema) during severe AKI allowed many patients to escape RRT and did not seem to adversely affect survival compared with a strategy of immediate RRT. In addition, data suggest that a delayed strategy may reduce the rate of complications (such as catheter infection) and favor renal function recovery. Ongoing studies will have to both confirm these conclusions and clarify to what extent the delay in initiating RRT can be prolonged. Pending those results, the bulk of evidence suggests that, in the absence of potential severe complications of AKI, delaying RRT is a valid and safe strategy that may also allow for considerable cost savings.
Indexed as
Identifiers
30785784What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.