Evidence map›Paper›PMID 34079944›Full record

ReviewCritical care explorations2021

Comparing Renal Replacement Therapy Modalities in Critically Ill Patients With Acute Kidney Injury: A Systematic Review and Network Meta-Analysis.

Zhikang Ye, Ying Wang, Long Ge, Gordon H Guyatt, David Collister, Waleed Alhazzani, Sean M Bagshaw, Emilie P Belley-Cote, Fang Fang, Liangying Hou and 17 more

Open access · goldAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Critical care explorations, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
26citing papers in PubMed, 4 pooled it
5.0field-weighted citation impact, top 4% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

26 citing papers in PubMed, 4 syntheses or guidelines pooled it, 48 citations in OpenAlex.

  1. [S3 guideline on sepsis-prevention, diagnosis, therapy, and follow-up care-update 2025].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2025
    Guideline
  2. Guideline
  3. Guideline
  4. Pooled it
  5. Trial
  6. Trial
  7. Review
  8. Article
  9. Article
  10. Clinical Profile and Survival Outcomes of Children with Acute Kidney Injury Requiring Renal Replacement Therapy: A Retrospective Study from a Tertiary Pediatric Intensive Care Unit.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2026
    Article
  11. Review
  12. Review
  13. Renal replacement therapy.Intensive care medicine · 2025
    Article
  14. Review
  15. Article
  16. Article
  17. Review
  18. Review
  19. Article
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

27 authors at 8 institutions in 2 countries.

Zhikang YeDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
Ying WangDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
Long GeEvidence Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China.
Gordon H GuyattDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
David CollisterDivision of Nephrology, University of Manitoba, Winnipeg, MB, Canada.
Waleed AlhazzaniDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
Sean M BagshawDepartment of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta and Alberta Health Services, Edmonton, AB, Canada.
Emilie P Belley-CoteDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
Fang FangDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
Liangying HouEvidence Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China.
Philipp KolbMichael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada.
Francois LamontagneUniversité de Sherbrooke, Sherbrooke, QC, Canada.
Simon OczkowskiDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
Lonnie PyneDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
Christian RabbatDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
Matt ScaumHamilton Health Sciences, Hamilton, ON, Canada.
Borna Tadayon NajafabadiDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
Wimonchat TangamornsuksanDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
Ron WaldDivision of Nephrology, St. Michael's Hospital, Toronto, ON, Canada.
Qi WangDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
Michael WalshDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
Liang YaoDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
Linan ZengDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
Abdullah Mohammed AlgarniFamily medicine department, Aseer Centeral Hospital, Abha, Saudi Arabia.
Rachel J CoubanDeGroote Institute for Pain Research and Care, McMaster University, Hamilton, ON, Canada.
Paul Elias AlexanderDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
Bram RochwergDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
McMaster University · CAImpact · CALanzhou University · CNHamilton Health Sciences · CASt. Michael's Hospital · CAUniversité de Sherbrooke · CAUniversity of Alberta · CAUniversity of Manitoba · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo compare different modalities of renal replacement therapy in critically ill adults with acute kidney injury. DATA SOURCES: We searched Medline, PubMed, Embase, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov from inception to 25 May, 2020. We included randomized controlled trials comparing the efficacy and safety of different renal replacement therapy modalities in critically ill patients with acute kidney injury. STUDY SELECTION: Ten reviewers (working in pairs) independently screened studies for eligibility, extracted data, and assessed risk of bias. DATA EXTRACTION: We performed random-effects frequentist network meta-analyses and used the Grading of Recommendations, Assessment, Development, and Evaluation approach to assess certainty of evidence. The primary analysis was a four-node analysis: continuous renal replacement therapy, intermittent hemodialysis, slow efficiency extended dialysis, and peritoneal dialysis. The secondary analysis subdivided these four nodes into nine nodes including continuous veno-venous hemofiltration, continuous veno-venous hemodialysis, continuous veno-venous hemodiafiltration, continuous arterio-venous hemodiafiltration, intermittent hemodialysis, intermittent hemodialysis with hemofiltration, slow efficiency extended dialysis, slow efficiency extended dialysis with hemofiltration, and peritoneal dialysis. We set the minimal important difference threshold for mortality as 2.5% (relative difference, 0.04). DATA SYNTHESIS: Thirty randomized controlled trials (

conclusionsThe results of this network meta-analysis suggest there is no difference in mortality between continuous renal replacement therapy and intermittent hemodialysis although continuous renal replacement therapy may increases renal recovery compared with intermittent hemodialysis. Slow efficiency extended dialysis with hemofiltration may be the most effective intervention at reducing mortality. Peritoneal dialysis is associated with good efficacy, and the least number of complications however may not be practical in all settings. Importantly, all conclusions are based on very low to moderate certainty evidence, limited by imprecision. At the very least, ICU clinicians should feel comfortable that the differences between continuous renal replacement therapy, intermittent hemodialysis, slow efficiency extended dialysis, and, where clinically appropriate, peritoneal dialysis are likely small, and any of these modalities is a reasonable option to employ in critically ill patients.

Indexed as

continuous renal replacement therapycritically illintermittent hemodialysisnetwork meta-analysis; renal replacement therapy

Identifiers

PMID34079944
PMCPMC8162503
OpenAlexW3161654996

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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.