Renal Replacement Therapy in Critically ill Patients: Navigating the Timing Debate

Acute kidney injury (AKI) is a frequent complication in critically ill patients and is associated with high mortality. While renal replacement therapy (RRT) remains a cornerstone of supportive care for severe AKI, the optimal circumstances for RRT initiation in critically ill patients is a longstanding subject of debate. This narrative review aims to provide an up to date summary of the evidence regarding timing of RRT initiation in the intensive care unit (ICU) and its impact on clinical outcomes. Additionally, management strategies for patients while RRT is delayed are suggested and means to identify patients who have a high probability of receiving RRT are explored.