Multidisciplinary guidelines on renal replacement therapy in intensive care medicine

Area of Science:

• Nephrology
• Intensive Care Medicine
• Critical Care

Background:

• Acute kidney injury (AKI) is common in critically ill patients.
• Renal replacement therapy (RRT) is frequently required for AKI management.
• Guidelines are needed for RRT in the intensive care unit (ICU) setting.

Purpose of the Study:

• To develop evidence-based guidelines for RRT in critically ill patients with AKI.
• To provide recommendations on key aspects of RRT management.
• To establish best practices for dialysis-dependent AKI in the ICU.

Main Methods:

• Systematic literature research was conducted.
• A Delphi process involved a bi-national multidisciplinary consensus panel (22 clinicians).
• Expert consensus guided the development of evidence-based statements and recommendations.

Main Results:

• Seven clinical areas requiring guidance were identified: start, modality, continuous/intermittent RRT, anticoagulation, dose, pharmacotherapy, and stopping criteria.
• A total of 73 statements and recommendations were produced.
• 47 key statements and recommendations are summarized in this overview.

Conclusions:

• This bi-national guideline offers evidence-based recommendations for RRT in critically ill patients with AKI.
• It aims to guide physicians in delivering optimal care for dialysis-dependent AKI.
• The guideline promotes best practices in intensive care units.