Early versus late renal replacement therapy in acute kidney injury: the search for a definition of timing continues
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* Corresponding author: Jonathan Bannard-Smith jonbannardsmith@doctors.org.uk
Department of Anaesthesia & Critical Care, Royal Blackburn Hospital, Haslingden Road, Blackburn BB2 3HH, UK
Critical Care 2011, 15:437 doi:10.1186/cc10275
See related research by Karvellas et al., http://ccforum.com/content/15/1/R72
Published: 29 July 2011First paragraph (this article has no abstract)
We read with interest the systematic review by Karvellas and colleagues on early versus late renal replacement therapy (RRT) in critically ill patients with acute kidney injury (AKI) [1]. The authors rightly cite enormous heterogeneity between the 15 studies reviewed as a key concern. We would like to focus on the varied approach and lack of consensus in defining early and late initiation of RRT, as all of the 15 studies quote different definitions in their methods. Even those utilising similar markers and criteria for AKI - for example, the RIFLE criteria [2] (two studies) or blood urea and nitrogen (four studies) - utilised and interpreted them in very different ways when distinguishing early and late initiation of RRT.