SynthesisBMC nephrology2026
Timing of renal-replacement therapy in patients with acute kidney injury and sepsis: a systematic review and meta-analysis.
Synthesis in BMC nephrology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe optimal timing for initiating renal replacement therapy (RRT) in sepsis-associated acute kidney injury (AKI) patients remains controversial. Early RRT initiation offers benefits by preventing metabolic complications and fluid overload, while delayed initiation avoids unnecessary procedures and conserves resources. This systematic review and meta-analysis aimed to compare early versus delayed RRT strategies in adult patients with sepsis-associated AKI.
methodsWe conducted a comprehensive search on PubMed, Scopus, Web of Science, and Cochrane CENTRAL from inception to February 2026. We included randomized controlled trials (RCTs) and observational cohorts comparing early versus delayed RRT initiation in patients with sepsis-associated AKI. Outcomes included 28-day and 90-day mortality, multi-organ dysfunction score (MODS), and intensive care unit (ICU) and hospital length of stay. Data were pooled using random-effects models.
resultsFifteen studies (4 RCTs, 11 retrospective cohorts) comprising 6,289 patients were included. Early RRT was associated with significant reduction in 28-day mortality compared to delayed RRT (RR 0.81, 95% CI: 0.68-0.95, p = 0.01; I²=31.38%). However, trim-and-fill analysis suggested potential publication bias, with adjusted estimates showing non-significance (RR 0.88, 95% CI: 0.75-1.04). No significant differences were observed for 90-day mortality (RR 0.85, 95% CI: 0.69-1.04, p = 0.12), MODS (MD 0.24, 95% CI: -0.94-1.42, p = 0.69), ICU length of stay (MD -1.76, 95% CI: -4.18-0.66, p = 0.15), or hospital length of stay (MD 0.34, 95% CI: -3.24-3.92, p = 0.85).
conclusionEarly RRT initiation in sepsis-associated AKI was associated with reduction in 28-day mortality rates but did not result in any differences of 90-days mortality rates, and was not associated with improvements in MODS, suggesting that timing alone may not substantially alter long-term outcomes in this high-risk population. These findings are driven from mixed study designs with heterogeneity among the included patients, underscoring the need for more individualized approaches to RRT initiation in the future trials.
trial registrationNot applicable.
Indexed as
Identifiers
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.