TY - JOUR T1 - Renal replacement therapy in critically ill patients with acute kidney injury: 2020 nephrologist’s perspective JO - Nefrología (English Edition) T2 - AU - Valdenebro,María AU - Martín-Rodríguez,Leyre AU - Tarragón,Blanca AU - Sánchez-Briales,Paula AU - Portolés,Jose SN - 20132514 M3 - 10.1016/j.nefroe.2021.05.003 DO - 10.1016/j.nefroe.2021.05.003 UR - https://www.revistanefrologia.com/en-renal-replacement-therapy-in-critically-articulo-S2013251421000468 AB - Renal replacement therapies (RRT) as support for acute kidney injury in critically ill patients have become a routine and essential practice in their management, resulting in the widespread use of various techniques among these patients, such as intermittent hemodialysis (IHD), extended hemodialysis and continuous RRT (CRRT).In this review we aim to summarize current evidence of indication, choice of modality, timing of initiation, dosing and technical aspects of RRT. We carried out a narrative review based on guidelines, consensus documents by main working groups and the latest relevant clinical trials on RRT in the critically ill.We did not find enough evidence of any RRT modality having superior benefits in terms of patient survival, length of intensive care unit/hospital stay or renal outcomes among critically ill patients, in spite of optimization of clinical indication, modality, timing of initiation and intensity of initial therapy. This is still a controverted matter, since only early start of high-flux CRRT has been proven beneficial over IHD among hemodynamically unstable postoperative patients.Our objective is to portrait current RRT practices in multidisciplinary management of critically ill patients by intensive care and nephrology professionals. Implication of a nephrologist in the assessment of hemodynamic status, coexisting medical conditions, renal outcome expectations and management of resources could potentially have benefits at the time of RRT selection and troubleshooting. ER -