Early Initiation
  • May confer benefit, in particular in circumstances in which there is a perception that recovery from AKI is not imminent
  • Can theoretically facilitate more rapid correction of electrolyte and acid-base derangements and control of uraemia and mitigate fluid accumulation
  • Would prevent the occurrence of overt complications of AKI
  • May limit worsening of non-renal organ dysfunction (potential kidney-organ interactions)
  • Will result in initiation of RRT in a significant portion of patients who may have regained renal function with conservative management
Late Initiation
  • Has not been shown to lead to worse outcomes than early initiation
  • Prevents complications of RRT in subset of patients that did not require it:
    • Insertion of dialysis catheters
    • Exposure to extracorporeal circuits
    • Clearance of nutrients and medication
    • Iatrogenic haemodynamic instability
  • Reduces healthcare costs by limiting bedside workload and resource utilisation