RRT Selection for AKI Patients With Critical Illness

Area of Science:

• Nephrology
• Intensive Care Medicine
• Public Health

Background:

• Acute kidney injury (AKI) presents a significant challenge in Asian intensive care units (ICUs).
• Renal replacement therapy (RRT) is vital supportive care for severe AKI.
• Regional diversity in ethics, climate, geography, and economics influences RRT modality selection in Asia.

Purpose of the Study:

• To review the current landscape of RRT modalities used for AKI in Asian ICUs.
• To highlight the factors influencing the choice between different RRT methods.
• To emphasize the need for improved RRT infrastructure in certain Asian regions.

Main Methods:

• Review of current practices and literature on RRT for AKI in Asia.
• Analysis of factors influencing RRT modality selection (e.g., cost, infrastructure, patient condition).
• Discussion of the availability and accessibility of different RRT techniques across Asian healthcare settings.

Main Results:

• Extracorporeal blood purification is common, with intermittent RRT favored in developing nations due to cost and infrastructure.
• Continuous RRT is prevalent in developed Asian countries, often for hospital-acquired AKI with hemodynamic instability.
• Peritoneal dialysis shows promise but is less frequently utilized for AKI in the region.

Conclusions:

• Significant variability exists in AKI RRT provision across Asia.
• Economic and infrastructural disparities dictate the adoption of different RRT modalities.
• Enhancing sustainable infrastructure is essential to ensure equitable and optimal AKI care throughout Asia.