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ACUTE KIDNEY INJURY

IDEAL timing of renal replacement therapy in critical care

Nature Reviews Nephrology volume 15, pages 5–6 (2019)Cite this article

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The IDEAL-ICU study reports no mortality benefit of early versus delayed initiation of renal replacement therapy (RRT) in patients with early septic shock and acute kidney injury. In the delayed initiation group, 17% of patients required emergency RRT but more than one-third spontaneously recovered renal function and did not require RRT.

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References

  1. Pickkers, P. et al. The intensive care medicine agenda on acute kidney injury. Intensive Care Med. 43, 1198–1209 (2017).

    Article  CAS  Google Scholar 

  2. Ostermann, M. et al. Timing of renal replacement therapy in acute kidney injury. Contrib. Nephrol. 187, 106–120 (2016).

    Article  Google Scholar 

  3. Joannidis, M. & Forni, L. G. Clinical review: timing of renal replacement therapy. Crit. Care 15, 223 (2011).

    Article  Google Scholar 

  4. Zarbock, A. et al. Effect of early versus delayed initiation of renal replacement therapy on mortality in critically ill patients with acute kidney injury: the ELAIN randomized clinical trial. JAMA 315, 2190–2199 (2016).

    Article  CAS  Google Scholar 

  5. Gaudry, S. et al. Initiation strategies for renal-replacement therapy in the intensive care unit. N. Engl. J. Med. 375, 122–133 (2016).

    Article  Google Scholar 

  6. Barbar, S. D. et al. Timing of renal-replacement therapy in patients with acute kidney injury and sepsis. N. Engl. J. Med. 379, 1431–1442 (2018).

    Article  CAS  Google Scholar 

  7. Lehner, G. F. et al. Hemofiltration induces generation of leukocyte-derived CD31 + /CD41- microvesicles in sepsis. Ann. Intensive Care 7, 89 (2017).

    Article  Google Scholar 

  8. Lumlertgul, N. et al. Early versus standard initiation of renal replacement therapy in furosemide stress test non-responsive acute kidney injury patients (the FST trial). Crit. Care 22, 101 (2018).

    Article  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Clinical and Experimental Medicine, Faculty of Health Sciences, University of Surrey, Guildford, UK

    Lui G. Forni

  2. Intensive Care Unit, Royal Surrey County Hospital NHS Foundation Trust, Guildford, UK

    Lui G. Forni

  3. Division of Intensive Care and Emergency Medicine, Department of Internal Medicine, Medical University Innsbruck, Innsbruck, Austria

    Michael Joannidis

Authors
  1. Lui G. Forni
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  2. Michael Joannidis
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Corresponding author

Correspondence to Lui G. Forni.

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Competing interests

L.G.F and M.J. have received lecture honoraria from Baxter and Fresenius.

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Forni, L.G., Joannidis, M. IDEAL timing of renal replacement therapy in critical care. Nat Rev Nephrol 15, 5–6 (2019). https://doi.org/10.1038/s41581-018-0088-1

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