When should we start renal-replacement therapy in critically ill patients with acute kidney injury: do we finally have the answer?

摘要

Proposed algorithm for starting renal-replacement therapy for critically ill patients with moderate-to-severe acute kidney injury (adapted from [13, 14]). *Urgent indications include fluid overload (PaO2/FiO2 < 200 plus clinical perception); metabolic acidosis (pH < 7.20 or HCO3− < 12 mmol/L; hyperkalemia (K+  ≥ 6.0 mmol/L); and/or complications attributable to uremia (bleeding; encephalopathy; pericarditis)