Nonurgent Renal Replacement Therapy for Patients with Acute Renal Injury

Delaying initiation of RRT for as long as 96 hours was not associated with excess mortality among patients in the ICU.

A recent randomized trial demonstrated the safety of delaying initiation of renal replacement therapy (RRT) in the intensive care unit (ICU) for 12 hours in patients with acute kidney injury (AKI) but without emergency indications for RRT (NEJM JW Gen Med Aug 15 2020 and N Engl J Med 2020; 383:240). Would a longer delay provide more benefit?

The same investigators performed a post hoc analysis of the 900 patients who were randomized to the standard arm (i.e., those in whom RRT was not initiated early) and who eventually received RRT. On average, patients who started dialysis later had more-favorable baseline physiological parameters (e.g., higher pH, higher urine output, lower potassium) at the time of RRT initiation.

When patients were divid…

Reviewing Author

Michael Billington, MD

Disclosures

Nothing to disclose

Michael Billington, MD

Disclosures

Nothing to disclose

Nonurgent Renal Replacement Therapy for Patients with Acute Renal Injury

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Reviewing Author