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In the subgroup analyses, there were no differences between patients who underwent earlier and later RRT in the majority of subgroups, with three exceptions.
There were also no significant differences in the ICU and hospital LOS between patients who underwent earlier versus later RRT [standard means difference −0.08 (95% CI −0.26 to 0.09) and −0.11 (95% CI −0.37 to 0.16) day, respectively].
Among the included trials, the pooled mortality rates were 38.7% (309 of 798) and 42.5% (352 of 829) in the groups of patients who underwent earlier and later RRT, respectively.
In the current systematic review of nine RCT including 1627 critically ill patients with AKI, who received RRT, we did not find any significant survival benefits in patients who underwent earlier versus later RRT.
Furthermore, 30-, 60-, and 90-day mortality, dialysis dependence, and LOS in the hospital or ICU were not lower in patients who underwent earlier RRT in comparison with those who underwent later RRT.
Pooled estimates of included studies indicated no significant survival benefit in patients who underwent earlier RRT compared with those who underwent later RRT, with an RR of 0.88 (95% CI 0.68 1.14, p = 0.33) (Fig. 2).
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