Choice of renal replacement therapy modality and dialysis dependence after acute kidney injury: a systematic review and meta-analysis

@article{Schneider2013ChoiceOR,
  title={Choice of renal replacement therapy modality and dialysis dependence after acute kidney injury: a systematic review and meta-analysis},
  author={Antoine Guillaume Schneider and Rinaldo Bellomo and Sean M. Bagshaw and Neil J Glassford and Serigne Lo and Min Jun and Alan Cass and Martin P. Gallagher},
  journal={Intensive Care Medicine},
  year={2013},
  volume={39},
  pages={987-997}
}
PurposeChoice of renal replacement therapy (RRT) modality may affect renal recovery after acute kidney injury (AKI). We sought to compare the rate of dialysis dependence among severe AKI survivors according to the choice of initial renal replacement therapy (RRT) modality applied [continuous (CRRT) or intermittent (IRRT)].MethodsSystematic searches of peer-reviewed publications in MEDLINE and EMBASE were performed (last update July 2012). All studies published after 2000 reporting dialysis… 
Effect of renal replacement therapy modalities on renal recovery and mortality for acute kidney injury: A PRISMA‐compliant systematic review and meta‐analysis
TLDR
The present study indicated no significant differences in renal recovery, in‐hospital mortality, and in‐ICU mortality between AKI patients given CRRT and those given sustained low‐efficiency dialysis (SLED).
Effects of continuous and intermittent renal replacement therapies among adult patients with acute kidney injury
TLDR
Assessment of differences between CRRT and IRRT regarding important clinical outcomes and cost-effectiveness show that initial CRRT is associated with higher rates of renal recovery and transferability of the economic analyzes to the German health care system is limited.
Extended Daily Dialysis Versus Continuous Renal Replacement Therapy for Acute Kidney Injury: A Meta-analysis.
TLDR
In both RCTs and observational studies, there were no significant differences in recovery of kidney function, fluid removal, or days in the intensive care unit, and EDD showed similar biochemical efficacy to CRRT during treatment (serum urea, serum creatinine, and serum phosphate).
Original Investigation Extended Daily Dialysis Versus Continuous Renal Replacement Therapy for Acute Kidney Injury: A Meta-analysis
TLDR
In both RCTs and observational studies, there were no significant differences in recovery of kidney function, fluid removal, or days in the intensive care unit, and EDD showed similar biochemical efficacy to CRRT during treatment.
Renal replacement therapy intensity for acute kidney injury and recovery to dialysis independence: a systematic review and individual patient data meta-analysis
  • Ying Wang, M. Gallagher, R. Bellomo
  • Medicine
    Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
  • 2018
TLDR
In severe AKI patients, higher intensity RRT does not affect mortality but appears to delay renal recovery.
The impact of continuous renal replacement therapy on renal outcomes in dialysis-requiring acute kidney injury may be related to the baseline kidney function
TLDR
The study showed that the incidence of D-AKI increased with illness severity, and the use of CRRT also increased over time; the improvement in renal outcomes observed in the CRRT group may be related to the better baseline kidney function, especially in the dialysis dependence patients at hospital discharge.
Earlier versus later initiation of renal replacement therapy among critically ill patients with acute kidney injury: a systematic review and meta-analysis of randomized controlled trials
TLDR
Compared with later RRT, earlier initiation of RRT did not show beneficial impacts on patient outcomes, however, a lower rate of death was observed among surgical patients and in those who underwent CRRT.
Renal replacement therapy in the ICU: intermittent hemodialysis, sustained low-efficiency dialysis or continuous renal replacement therapy?
TLDR
There is lack of solid evidence showing superiority of any mode of RRT in patients with severe AKI in terms of patient survival, and patients’ hemodynamic status, coexisting medical conditions, local expertise, and availability of staff and resources as well as potential effect on long-term renal outcomes should be taken into consideration when selecting modalities of R RT.
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