Introduction. Acute kidney injury (AKI) is a frequent and clinically important complication in adults receiving extracorporeal membrane oxygenation (ECMO), yet reported incidence and associated outcomes vary widely due to differences in populations, ECMO configuration, and AKI definitions. We systematically reviewed full-text studies reporting AKI and related outcomes in adult patients supported with veno-arterial (VA) and/or venovenous (VV) ECMO.Methods. A systematic search of PubMed identified 661 records; 660 remained after deduplication. Full texts available for assessment were screened for eligibility (n = 126). We included original adult ECMO/ECLS studies reporting extractable AKI and/or renal replacement therapy (RRT/CRRT) outcomes.Results. Forty-five studies were included in qualitative synthesis. AKI incidence was extractable in 29 studies and ranged from 2.3% to 89.0% (median 50.5%). RRT/CRRT use was extractable in 29 studies and ranged from 1.8% to 91.0% (median 53.3%). Mortality was extractable in 37 studies (ICU, in-hospital, or 30day) and ranged from 6.0% to 95.0% (median 53.3%). KDIGO was the most frequently referenced AKI definition (reported in 26 studies), followed by RIFLE (19) and AKIN (11), with overlap across studies.Conclusions. AKI and RRT/CRRT use are common in adults receiving ECMO, with substantial variability driven by clinical heterogeneity and inconsistent AKI definitions and outcome reporting. Standardized AKI definitions and harmonized reporting of renal and mortality outcomes are needed to improve comparability and guide future ECMO–kidney research.
Tripathi et al. (Sat,) studied this question.