Abstract
To assess the effects of delayed versus early renal replacement therapy (RRT) initiation for patients with AKI. Related RCTs of RRT initiated at different times published on PubMed, Web of Science, Embase, and Cochrane Library were searched. Fifteen RCTs studies with 5395 patients were included. The results showed that the 28-day mortality (RR 1.01; 95% CI 0.94 ~ 1.08; p=0.80), 60-day mortality (RR 1.00; 95% CI 0.91 ~ 1.11; p=0.93), 90-day mortality (RR 1.01; 95% CI 0.94 ~ 1.08; p=0.80), dialysis dependence among survivors (RR 0.67; 95% CI 0.40 ~ 1.13; p=0.13), length of ICU stay (RR -1.32; 95% CI -3.26 ~ 0.62; p=0.18) and length of hospital stay among survivors(RR -0.98; 95% CI -2.89 ~ 0.92; p=0.31) were not significantly different between the two groups. In addition, early initiation of RRT increases the incidence of hypotension (RR 1.42, 95% CI 1.23 ~ 1.63; p< 0.00001) and infectious (RR 1.36; 95% CI 1.03 ~ 1.80; p=0.03) events. Early initiation of RRT cannot improve the prognosis and benefit patients.
Published Version
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