Weaning from renal replacement therapy in the critically ill patient with acute kidney injury
Why ? When ? How ?
Keywords:Acute Kidney Injury, Renal Replacement Therapy (RRT), RRT weaning, urine output, creatinine clearance, urinary urea, urinary creatinine, urinary biomarkers
About 10% of ICU patients suffer from acute kidney injury (AKI) requiring renal replacement therapy (RRT) with a mortality rate around 50%. Though most survivors achieve sufficient renal recovery to be weaned from RRT, there are no recognized guidelines data on the optimal period for RRT weaning. Both an unjustified delay and a too early RRT weaning lead to numerous complications. Consequently, RRT weaning must be carried out as early as possible and under the best possible conditions. This review provides the justifications for early RRT weaning, the parameters likely to guide it, and its practical modalities.