COMPARISON BETWEEN EARLY INITIATION AND STANDARD STRATEGY OF RENAL REPLACEMENT THERAPY IN THE CRITICALLY ILL ACUTE KIDNEY INJURY PATIENTS

Vinu Jamwal*

ABSTRACT

Introduction: Acute kidney injury is a medical condition with multiple etiologies that affects 5% of hospital admissions and 30% of intensive care unit (ICU) admissions. The relationship between early initiation of renal replacement therapy or delay in renal replacement therapy in critically ill patients with non-life-threatening kidney damage due to renal failure is a major issue faced by clinicians. In this study, the average age of the research participants in the early intervention group was 47.1±8.76 years, and the average age of the participants in the delayed intervention group was 46.04±7.34 years. Primary and secondary outcomes were not significantly different. Materials and Methods: This prospective observational study was conducted after getting approval from institutional ethical committee. We included patients >18 years of age with Stage 3 AKI according to KDIGO guidelines in our study. Patients with CKD and previous exposure to RRT were excluded from the study. The clinical profile, lab investigations and outcome of study participants were recorded. This study was done over a period of 6 months i.e, from July 2023 to December 2023. Results: The study had 100 participants. The average age of the study participants was 47.1± 8.76 years in early strategy group and 46.04±7.34 years in standard strategy group. The current study reported no statistically significant association between the timing of dialysis in the critically ill acute kidney injury patients in terms of primary and secondary outcome for the same. Concluasion: Renal replacement should be individualized.

Keywords: Acute kidney injury, Renal replacement therapy, Early strategy, Standard strategy, Mechanical ventilation.