ArticleIntensive care medicine2026
Trends in renal replacement therapy use in intensive care unit: insights from a French multicenter cohort.
Article in Intensive care medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Low-intensity versus medium-intensity continuous renal replacement therapy for critically ill patients (LIMIT) trial: Protocol summary and statistical analysis plan of a randomised clinical trial.Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2026Article
- Occupational heatstroke-induced acute kidney injury: a narrative review of mechanisms, biomarkers, and the timing of blood purification initiation.Renal failure · 2026Review
- Acute kidney injury among intensive care unit patients in Denmark: temporal changes in mortality and kidney outcomes from 2010 to 2024.Critical care (London, England) · 2026Article
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionRenal replacement therapy (RRT) during acute kidney injury (AKI) in critically ill patients used to be started early for long. Recent trials supporting a conservative approach with delayed RRT initiation may have influenced clinical practice. We aim to assess temporal trends in the use of RRT among intensive care unit (ICU) patients with AKI over a 12-year period. MATERIALS AND
methodsWe conducted a retrospective cohort study using data from the CUB-Réa database, including ICU patients with AKI who required invasive mechanical ventilation and/or catecholamine infusion between 2008 and 2019. Patients were grouped into three periods based on the calendar year of ICU stay: 2008-2011, 2012-2015, and 2016-2019. The primary outcome was the temporal trend in RRT utilization. Secondary outcomes included annual crude RRT rates per 1000 ICU stays and trends in RRT modality. Multivariable logistic regression was used to adjust for confounders. We used a monthly interrupted time series (ITS) over 2008-2019 with a prespecified breakpoint at July 2016 (AKIKI trial publication).
resultsAmong 45,242 eligible ICU stays, 16,999 (37.6%) required RRT. The use of RRT decreased over the study period, from 39.7% in 2008-2011 to 37.4% in 2012-2015, and to 35.9% in 2016-2019 (p < 0.0001). Adjusted analyses confirmed this trend, with an odds ratio (OR) of 0.91 (95% CI 0.87-0.96) for 2012-2015 and 0.80 (95% CI 0.76-0.84) for 2016-2019, compared to the baseline period. In the adjusted ITS analysis, only the post-intervention monthly trend reached statistical significance (RR per year = 0.97; 95% CI 0.94-0.99). The annual crude rate of RRT use declined from 441 per 1000 ICU stays at baseline to 339 in 2019 (relative reduction: 20.8%). Use of intermittent RRT declined, while continuous modestly increased.
conclusionsAmong critically ill patients with AKI, RRT use decreased in the past decade. This suggests a progressive shift toward more conservative RRT initiation strategies.
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