SynthesisPloS one2019
Early versus late initiation of renal replacement therapy for acute kidney injury in critically ill patients: A systematic review and meta-analysis.
Synthesis in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
What it found
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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
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 24 citations in OpenAlex.
- Accelerated-strategy renal replacement therapy for critically ill patients: A systematic review and meta-analysis.Medicine · 2022Pooled it
- Early-start vs. conventional-start peritoneal dialysis in AKI from cardiorenal syndrome type 1: a randomized controlled trial (STARRT-PD).International urology and nephrology · 2026Article
- Impact of Early Initiation of Renal Replacement Therapy on Renal Recovery and Mortality in Critically Ill Patients with Acute Kidney Injury: A Prospective Cohort Study.Biomedicines · 2025Article
- Outcomes of continuous kidney replacement therapy in pediatric patients: the impact of timing and predictors of mortality.Pediatric nephrology (Berlin, Germany) · 2025Article
- Impact of Precision in Staging Acute Kidney Injury and Chronic Kidney Disease on Treatment Outcomes: An Observational Study.Diagnostics (Basel, Switzerland) · 2024Article
- Acute Kidney Injury among Hospital-Admitted COVID-19 Patients: A Study from Jordan.International journal of general medicine · 2022Article
- COVID-19-associated acute respiratory distress syndrome (CARDS): Current knowledge on pathophysiology and ICU treatment - A narrative review.Best practice & research. Clinical anaesthesiology · 2021Review
- Article
- Body Mass Index Is Associated with the Severity and All-Cause Mortality of Acute Kidney Injury in Critically Ill Patients: An Analysis of a Large Critical Care Database.BioMed research international · 2021Article
- Timing of Initiation of Renal Replacement Therapy in Sepsis-Associated Acute Kidney Injury.Journal of clinical medicine · 2020Review
- Incidence, Risk Factors, and Outcome of Acute Kidney Injury in the Intensive Care Unit: A Single-Center Study from Jordan.Critical care research and practice · 2020Article
- The Association Between Chronic Kidney Disease and New Onset Renal Replacement Therapy on the Outcome of COVID-19 Patients: A Meta-analysis.Clinical medicine insights. Circulatory, respiratory and pulmonary medicine · 2020Article
- Timing of kidney replacement therapy in critically ill patients: A call to shift the paradigm in the era of artificial intelligence.Science progressReview
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAcute kidney injury is associated with high mortality, and is the most frequent complication encountered in patients residing in the intensive care unit. Although renal replacement therapy (RRT) is the standard of care for acute kidney injury, the optimal timing for initiation is still unknown.
methodsWe conducted a systemic review and meta-analysis of randomized controlled trials evaluating early versus late initiation of RRT in critically ill patients with acute kidney injury. We searched MEDLINE, Embase, and CENTRAL databases from inception to October 15, 2018. We screened studies and extracted data from published reported independently. The primary outcome was short-term mortality.
resultsA total of 2242 patients were included from 11 trials. No statistically significant effect was found for early versus late initiation of RRT on short-term mortality (risk ratio [RR] 0.99, 95% CI 0.84-1.17, p = 0.93) or long-term mortality (RR 0.98, 95% CI 0.85-1.13, p = 0.76). There were also no statistically significant effects on ICU length of stay, hospital length of stay, recovery of renal function, and renal replacement therapy dependence. Early initiation of RRT decreased the risk of metabolic acidosis (RR 0.65, 95% CI 0.43-0.99, p = 0.04), but increased the risk of hypotension (RR 1.24, 95% CI 1.08-1.43, p = 0.003).
conclusionsIn critically ill patients with acute kidney injury, early compared with late initiation of RRT is not associated with favorable mortality outcomes, although it appears to reduce the risk of metabolic acidosis.
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What 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.