Systematic review compares early and delayed renal replacement therapy impacts on mortality in sepsis-associated acute kidney injury patients, suggesting needs for tailored approaches.
Key Points
This review aims to evaluate the effects of early versus delayed renal replacement therapy initiation in patients with sepsis-associated acute kidney injury.
Conducted a systematic review and meta-analysis of studies from PubMed, Scopus, Web of Science, and Cochrane CENTRAL up to February 2026.
Included randomized controlled trials and observational cohorts comparing early versus delayed RRT in sepsis-associated AKI patients.
Pooled data using random-effects models to assess various outcome measures.
Early RRT reduced 28-day mortality compared to delayed initiation (RR 0.81, 95% CI: 0.68–0.95, p = 0.01).
No significant differences in 90-day mortality (RR 0.85, 95% CI: 0.69–1.04, p = 0.12) or multi-organ dysfunction score (MD 0.24, 95% CI: -0.94–1.42, p = 0.69).
Early RRT did not improve ICU or hospital length of stay significantly (ICU: MD -1.76, 95% CI: -4.18–0.66, p = 0.15; Hospital: MD 0.34, 95% CI: -3.24–3.92, p = 0.85).