When and why to start continuous renal replacement therapy in critically ill patients with acute kidney injury
Acute kidney injury (AKI) is a common condition in critically ill patients, and may contribute to significant medical, social, and economic consequences, including death. Although there have been advances in medical technology, including continuous renal replacement therapy (CRRT), the mortality rat...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
The Korean Society of Nephrology
2021-12-01
|
| Series: | Kidney Research and Clinical Practice |
| Subjects: | |
| Online Access: | http://www.krcp-ksn.org/upload/pdf/j-krcp-21-043.pdf |
| _version_ | 1828430475805327360 |
|---|---|
| author | Jung Nam An Sung Gyun Kim Young Rim Song |
| author_facet | Jung Nam An Sung Gyun Kim Young Rim Song |
| author_sort | Jung Nam An |
| collection | DOAJ |
| description | Acute kidney injury (AKI) is a common condition in critically ill patients, and may contribute to significant medical, social, and economic consequences, including death. Although there have been advances in medical technology, including continuous renal replacement therapy (CRRT), the mortality rate of AKI is high, and there is no fundamental treatment that can reverse disease progression. The decision to implement CRRT is often subjective and based primarily on the clinician’s judgment without consistent and concrete guidelines or protocols regarding when to initiate and discontinue CRRT and how to manage complications. Recently, several randomized controlled trials addressing the initiation of renal replacement therapy in critically ill patients with AKI have been completed, but clinical application of the findings is limited by the heterogeneity of the objectives and research designs. In this review, the advantages and disadvantages of CRRT initiation, clinical guideline recommendations, and the results of currently published clinical trials and meta-analyses are summarized to guide patient care and identify future research priorities. |
| first_indexed | 2024-12-10T17:49:08Z |
| format | Article |
| id | doaj.art-1e0507c20c43486faf64e0b99da95534 |
| institution | Directory Open Access Journal |
| issn | 2211-9132 2211-9140 |
| language | English |
| last_indexed | 2024-12-10T17:49:08Z |
| publishDate | 2021-12-01 |
| publisher | The Korean Society of Nephrology |
| record_format | Article |
| series | Kidney Research and Clinical Practice |
| spelling | doaj.art-1e0507c20c43486faf64e0b99da955342022-12-22T01:39:07ZengThe Korean Society of NephrologyKidney Research and Clinical Practice2211-91322211-91402021-12-0140456657710.23876/j.krcp.21.0436074When and why to start continuous renal replacement therapy in critically ill patients with acute kidney injuryJung Nam An0Sung Gyun Kim1Young Rim Song2 Division of Nephrology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea Division of Nephrology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea Division of Nephrology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Republic of KoreaAcute kidney injury (AKI) is a common condition in critically ill patients, and may contribute to significant medical, social, and economic consequences, including death. Although there have been advances in medical technology, including continuous renal replacement therapy (CRRT), the mortality rate of AKI is high, and there is no fundamental treatment that can reverse disease progression. The decision to implement CRRT is often subjective and based primarily on the clinician’s judgment without consistent and concrete guidelines or protocols regarding when to initiate and discontinue CRRT and how to manage complications. Recently, several randomized controlled trials addressing the initiation of renal replacement therapy in critically ill patients with AKI have been completed, but clinical application of the findings is limited by the heterogeneity of the objectives and research designs. In this review, the advantages and disadvantages of CRRT initiation, clinical guideline recommendations, and the results of currently published clinical trials and meta-analyses are summarized to guide patient care and identify future research priorities.http://www.krcp-ksn.org/upload/pdf/j-krcp-21-043.pdfacute kidney injurycontinuous renal replacement therapyguidelinemeta-analysisrandomized controlled trial |
| spellingShingle | Jung Nam An Sung Gyun Kim Young Rim Song When and why to start continuous renal replacement therapy in critically ill patients with acute kidney injury Kidney Research and Clinical Practice acute kidney injury continuous renal replacement therapy guideline meta-analysis randomized controlled trial |
| title | When and why to start continuous renal replacement therapy in critically ill patients with acute kidney injury |
| title_full | When and why to start continuous renal replacement therapy in critically ill patients with acute kidney injury |
| title_fullStr | When and why to start continuous renal replacement therapy in critically ill patients with acute kidney injury |
| title_full_unstemmed | When and why to start continuous renal replacement therapy in critically ill patients with acute kidney injury |
| title_short | When and why to start continuous renal replacement therapy in critically ill patients with acute kidney injury |
| title_sort | when and why to start continuous renal replacement therapy in critically ill patients with acute kidney injury |
| topic | acute kidney injury continuous renal replacement therapy guideline meta-analysis randomized controlled trial |
| url | http://www.krcp-ksn.org/upload/pdf/j-krcp-21-043.pdf |
| work_keys_str_mv | AT jungnaman whenandwhytostartcontinuousrenalreplacementtherapyincriticallyillpatientswithacutekidneyinjury AT sunggyunkim whenandwhytostartcontinuousrenalreplacementtherapyincriticallyillpatientswithacutekidneyinjury AT youngrimsong whenandwhytostartcontinuousrenalreplacementtherapyincriticallyillpatientswithacutekidneyinjury |