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Abstract

Acute kidney injury (AKI) is a common complication among critically ill patients supported in an intensive care unit (ICU) setting [1]. Recent epidemiologic data indicate the incidence of AKI is increasing and may characterize the ICU course in up to two-thirds of patients [2–5]. Among those with more severe AKI or those with complications attributable to AKI, renal replacement therapy (RRT) is commonly initiated [6, 7].

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References

  1. Bellomo R, Kellum JA, Ronco C. Acute kidney injury. Lancet. 2012;380:756–66.

    Article  PubMed  Google Scholar 

  2. Bagshaw SM, George C, Bellomo R. Changes in the incidence and outcome for early acute kidney injury in a cohort of Australian intensive care units. Crit Care. 2007;11:R68.

    Article  PubMed Central  PubMed  Google Scholar 

  3. Hsu RK, McCulloch CE, Dudley RA, Lo LJ, Hsu CY. Temporal changes in incidence of dialysis-requiring AKI. J Am Soc Nephrol. 2013;24:37–42.

    Article  PubMed  Google Scholar 

  4. Vaara ST, Pettila V, Reinikainen M, Kaukonen KM. Population-based incidence, mortality and quality of life in critically ill patients treated with renal replacement therapy: a nationwide retrospective cohort study in Finnish intensive care units. Crit Care. 2012;16:R13.

    Article  PubMed Central  PubMed  Google Scholar 

  5. Hoste EA, Clermont G, Kersten A, et al. RIFLE criteria for acute kidney injury are associated with hospital mortality in critically ill patients: a cohort analysis. Crit Care. 2006;10:R73.

    Article  PubMed Central  PubMed  Google Scholar 

  6. Nisula S, Kaukonen KM, Vaara ST, et al. Incidence, risk factors and 90-day mortality of patients with acute kidney injury in Finnish intensive care units: the FINNAKI study. Intensive Care Med. 2013;39:420–8.

    Article  PubMed  Google Scholar 

  7. Uchino S, Kellum JA, Bellomo R, et al. Acute renal failure in critically ill patients: a multinational, multicenter study. JAMA. 2005;294:813–8.

    Article  CAS  PubMed  Google Scholar 

  8. Hamel MB, Phillips RS, Davis RB, et al. Outcomes and cost-effectiveness of initiating dialysis and continuing aggressive care in seriously ill hospitalized adults. SUPPORT Investigators. Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments. Ann Intern Med. 1997;127:195–202.

    Article  CAS  PubMed  Google Scholar 

  9. Korkeila M, Ruokonen E, Takala J. Costs of care, long-term prognosis and quality of life in patients requiring renal replacement therapy during intensive care. Intensive Care Med. 2000;26:1824–31.

    Article  CAS  PubMed  Google Scholar 

  10. Wald R, Quinn RR, Luo J, et al. Chronic dialysis and death among survivors of acute kidney injury requiring dialysis. JAMA. 2009;302:1179–85.

    Article  CAS  PubMed  Google Scholar 

  11. Bagshaw SM, Laupland KB, Doig CJ, et al. Prognosis for long-term survival and renal recovery in critically ill patients with severe acute renal failure: a population-based study. Crit Care. 2005;9:R700–9.

    Article  PubMed Central  PubMed  Google Scholar 

  12. Joannidis M, Forni LG. Clinical review: timing of renal replacement therapy. Crit Care. 2011;15:223.

    Article  PubMed Central  PubMed  Google Scholar 

  13. Ricci Z, Ronco C, D’Amico G, et al. Practice patterns in the management of acute renal failure in the critically ill patient: an international survey. Nephrol Dial Transplant. 2006;21:690–6.

    Article  PubMed  Google Scholar 

  14. Bagshaw SM, Uchino S, Kellum J, et al. Association between renal replacement therapy in critically ill patients with severe acute kidney injury and mortality. J Crit Care. 2013;28(6):1011–8.

    Article  PubMed  Google Scholar 

  15. Clec’h C, Gonzalez F, Lautrette A, et al. Multiple-center evaluation of mortality associated with acute kidney injury in critically ill patients: a competing risks analysis. Crit Care. 2011;15:R128.

    Article  PubMed Central  PubMed  Google Scholar 

  16. Karvellas CJ, Farhat MR, Sajjad I, et al. A comparison of early versus late initiation of renal replacement therapy in critically ill patients with acute kidney injury: a systematic review and meta-analysis. Crit Care. 2011;15:R72.

    Article  PubMed Central  PubMed  Google Scholar 

  17. Seabra VF, Balk EM, Liangos O, Sosa MA, Cendoroglo M, Jaber BL. Timing of renal replacement therapy initiation in acute renal failure: a meta-analysis. Am J Kidney Dis. 2008;52:272–84.

    Article  PubMed  Google Scholar 

  18. Wang X, Jie Yuan W. Timing of initiation of renal replacement therapy in acute kidney injury: a systematic review and meta-analysis. Ren Fail. 2012;34:396–402.

    Article  CAS  PubMed  Google Scholar 

  19. Clark EG, Bagshaw SM. Unnecessary renal replacement therapy for acute kidney injury is harmful for renal recovery. Semin Dial. 2015;28(1):6–11.

    Article  PubMed  Google Scholar 

  20. Shiao CC, Ko WJ, Wu VC, et al. U-curve association between timing of renal replacement therapy initiation and in-hospital mortality in postoperative acute kidney injury. PLoS One. 2012;7, e42952.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  21. Ostermann M, Dickie H, Barrett NA. Renal replacement therapy in critically ill patients with acute kidney injury–when to start. Nephrol Dial Transplant. 2012;27(6):2242–8.

    Article  PubMed  Google Scholar 

  22. Bouchard J, Soroko SB, Chertow GM, et al. Fluid accumulation, survival and recovery of kidney function in critically ill patients with acute kidney injury. Kidney Int. 2009;76:422–7.

    Article  PubMed  Google Scholar 

  23. Prowle JR, Echeverri JE, Ligabo EV, Ronco C, Bellomo R. Fluid balance and acute kidney injury. Nat Rev Nephrol. 2010;6:107–15.

    Article  PubMed  Google Scholar 

  24. Sutherland SM, Zappitelli M, Alexander SR, et al. Fluid overload and mortality in children receiving continuous renal replacement therapy: the prospective pediatric continuous renal replacement therapy registry. Am J Kidney Dis. 2010;55(2):316–25.

    Article  PubMed  Google Scholar 

  25. Rimmele T, Kellum JA. Clinical review: blood purification for sepsis. Crit Care. 2011;15:205.

    Article  PubMed Central  PubMed  Google Scholar 

  26. Kidney Disease: Improving Global Outcomes (KDIGO) Acute Kidney Injury Work Group. KDIGO clinical practice guideline for acute kidney injury. Kidney Int. 2012;2012:1–138.

    Google Scholar 

  27. National Institute for Health and Care Excellence Acute Kidney Injury Workgroup. Acute kidney injury: prevention, detection and management of acute kidney injury up to the point of renal replacement therapy. Clinical guidelines, CG169. (http://guidance.nice.org.uk/CG169).

  28. Bouman CS, Oudemans-Van Straaten HM, Tijssen JG, Zandstra DF, Kesecioglu J. Effects of early high-volume continuous venovenous hemofiltration on survival and recovery of renal function in intensive care patients with acute renal failure: a prospective, randomized trial. Crit Care Med. 2002;30:2205–11.

    Article  PubMed  Google Scholar 

  29. Jamale TE, Hase NK, Kulkarni M, et al. Earlier-start versus usual-start dialysis in patients with community-acquired acute kidney injury: a randomized controlled trial. Am J Kidney Dis. 2013;62:1116–21.

    Article  PubMed  Google Scholar 

  30. Demirkilic U, Kuralay E, Yenicesu M, et al. Timing of replacement therapy for acute renal failure after cardiac surgery. J Card Surg. 2004;19:17–20.

    Article  PubMed  Google Scholar 

  31. Durmaz I, Yagdi T, Calkavur T, et al. Prophylactic dialysis in patients with renal dysfunction undergoing on-pump coronary artery bypass surgery. Ann Thorac Surg. 2003;75:859–64.

    Article  PubMed  Google Scholar 

  32. Elahi MM, Lim MY, Joseph RN, Dhannapuneni RR, Spyt TJ. Early hemofiltration improves survival in post-cardiotomy patients with acute renal failure. Eur J Cardiothorac Surg. 2004;26(5):1027–31.

    Article  PubMed  Google Scholar 

  33. Manche A, Casha A, Rychter J, Farrugia E, Debono M. Early dialysis in acute kidney injury after cardiac surgery. Interact Cardiovasc Thorac Surg. 2008;7:829–32.

    Article  PubMed  Google Scholar 

  34. Sugahara S, Suzuki H. Early start on continuous hemodialysis therapy improves survival rate in patients with acute renal failure following coronary bypass surgery. Hemodial Int. 2004;8:320–5.

    Article  PubMed  Google Scholar 

  35. Iyem H, Tavli M, Akcicek F, Buket S. Importance of early dialysis for acute renal failure after an open-heart surgery. Hemodial Int. 2009;13:55–61.

    Article  PubMed  Google Scholar 

  36. Andrade L, Cleto S, Seguro AC. Door-to-dialysis time and daily hemodialysis in patients with leptospirosis: impact on mortality. Clin J Am Soc Nephrol. 2007;2:739–44.

    Article  PubMed  Google Scholar 

  37. Gettings LG, Reynolds HN, Scalea T. Outcome in post-traumatic acute renal failure when continuous renal replacement therapy is applied early vs. late. Intensive Care Med. 1999;25:805–13.

    Article  CAS  PubMed  Google Scholar 

  38. Shiao CC, Wu VC, Li WY, et al. Late initiation of renal replacement therapy is associated with worse outcomes in acute kidney injury after major abdominal surgery. Crit Care. 2009;13:R171.

    Article  PubMed Central  PubMed  Google Scholar 

  39. Wu VC, Ko WJ, Chang HW, et al. Early renal replacement therapy in patients with postoperative acute liver failure associated with acute renal failure: effect on postoperative outcomes. J Am Coll Surg. 2007;205:266–76.

    Article  PubMed  Google Scholar 

  40. Carl DE, Grossman C, Behnke M, Sessler CN, Gehr TW. Effect of timing of dialysis on mortality in critically ill, septic patients with acute renal failure. Hemodial Int. 2010;14:11–7.

    Article  PubMed  Google Scholar 

  41. Liu KD, Himmelfarb J, Paganini E, et al. Timing of initiation of dialysis in critically ill patients with acute kidney injury. Clin J Am Soc Nephrol. 2006;1:915–9.

    Article  CAS  PubMed  Google Scholar 

  42. Bagshaw SM, Uchino S, Bellomo R, et al. Timing of renal replacement therapy and clinical outcomes in critically ill patients with severe acute kidney injury. J Crit Care. 2009;24:129–40.

    Article  PubMed  Google Scholar 

  43. Bagshaw SM, Wald R, Barton J, et al. Clinical factors associated with initiation of renal replacement therapy in critically ill patients with acute kidney injury-a prospective multicenter observational study. J Crit Care. 2012;27:268–75.

    Article  PubMed  Google Scholar 

  44. Vaara ST, Reinikainen M, Wald R, Bagshaw SM, Pettila V, for the FINNAKI Study Group FS. Timing of RRT based on the presence of conventional indications. Clin J Am Soc Nephrol. 2014;9:1577–85.

    Google Scholar 

  45. Uchino S, Bellomo R, Morimatsu H, et al. Discontinuation of continuous renal replacement therapy: a post hoc analysis of a prospective multicenter observational study. Crit Care Med. 2009;37:2576–82.

    Article  PubMed  Google Scholar 

  46. Wu VC, Ko WJ, Chang HW, et al. Risk factors of early redialysis after weaning from postoperative acute renal replacement therapy. Intensive Care Med. 2008;34:101–8.

    Article  CAS  PubMed  Google Scholar 

  47. Smith OM, Wald R, Adhikari NK, et al. Standard versus accelerated initiation of renal replacement therapy in acute kidney injury (STARRT-AKI): study protocol for a randomized controlled trial. Trials. 2013;14:320.

    Article  PubMed Central  PubMed  Google Scholar 

  48. Initiation of Dialysis Early Versus Late in Intensive Care Unit. ClinicalTrials.gov, 2013. Accessed 20 Dec 2014, at https://clinicaltrials.gov/ct2/show/NCT01682590.

  49. Artificial Kidney Initiation in Kidney Injury, a Multicenter Randomised Trial. ClinicalTrials.gov, 2013. Accessed 20 Dec 2014, at https://clinicaltrials.gov/ct2/show/NCT01932190.

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Correspondence to Sean M. Bagshaw MD, MSc, FRCPC .

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Ostermann, M., Wald, R., Pettilä, V., Bagshaw, S.M. (2015). Timing of Renal Replacement Therapy. In: Oudemans-van Straaten, H., Forni, L., Groeneveld, A., Bagshaw, S., Joannidis, M. (eds) Acute Nephrology for the Critical Care Physician. Springer, Cham. https://doi.org/10.1007/978-3-319-17389-4_12

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  • DOI: https://doi.org/10.1007/978-3-319-17389-4_12

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