• Huanhuan Tian, Ting Sun, Dong Hao, Tao Wang, Zhi Li, Shasha Han, Zhijiang Qi, Zhaoju Dong, Changjun Lv, and Xiaozhi Wang.
• Intensive Care Unit, Affiliated Hospital of Binzhou Medical University, 661 Yellow River Road, Binzhou, 256603, Shandong, People's Republic of China.
• Int Urol Nephrol. 2014 Oct 1;46(10):2009-14.

PurposeHigh mortality in the intensive care unit (ICU) is probably associated with sepsis-induced acute kidney injury (AKI). The aim of this study is to explore which stage of AKI may be the optimal timing for continuous renal replacement therapy (CRRT).MethodsA retrospective analysis of 160 critically ill patients with septic AKI, treated with or without CRRT was performed in Binzhou medical college affiliated hospital ICU. The parameters including 28-days mortality rate, renal recovery, ventilation time and ICU stay between CRRT group and control group were assessed.ResultsRenal recovery, defined as independence from dialysis at discharge, was documented for 64/76 (84.2 %) of the surviving patients (48.1 % of total subjects included in the study). The mortality rate increased proportionally with acute kidney injury Network stages in CRRT subgroups (P = 0.001) and control groups (P = 0.029). CRRT initiation at stage 2 of AKI significantly reduced the 28-day mortality (P = 0.048) and increased the 28-day survival rate (P = 0.036) compared with those in control group. In addition, the ICU stay and ventilation time were shorter in CRRT group than that of control group in stage 2 of AKI.ConclusionThe stage 2 AKI might be the optimal timing for performing CRRT.

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