• Diana Silva Russo, Claudia Severgnini Eugenio, Illan George Balestrin, Clarissa Garcia Rodrigues, Regis Goular Rosa, Cassiano Teixeira, Yvelynne P Kelly, and VieiraSilvia Regina RiosSRRUniversidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil..
• Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
• J Crit Care. 2022 Jun 1; 69: 153998153998.

PurposeTo compare hemodynamic instability during continuous, intermittent and hybrid renal replacement therapy (RRT) in critically ill patients, and its association with renal recovery and mortality.Materials And MethodsThe search was conducted in accordance with the PRISMA guidelines which was registered at the PROSPERO Database (CRD42018086504). Randomized clinical trials (RCTs) involving critically ill patients with acute kidney injury (AKI) treated with continuous, intermittent or hybrid RRT were included. The search was performed using PubMed, Embase and Cochrane databases.ResultsOut of 3442 citations retrieved, 12 RCTs were included in the systematic analysis, representing 1419 patients. Most studies (n = 8) did not report differences in hemodynamic parameters across different RTT modalities. The incidence of hypotensive episodes varied from 5 to 60% among the studies. Punctual differences on heart rate and blood pressure were observed among studies. However, studies presented high heterogeneity in terms of outcome definitions and measurement, thus making the conduction of meta-analysis impossible.ConclusionsThere is very few information available regarding hemodynamic tolerance of renal replacement therapy methods. A better standardization of hemodynamic tolerance and further reports are needed before conclusions can be drawn.Copyright © 2022 Elsevier Inc. All rights reserved.

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