• Xiaoyang Zhou, Pingping Dong, Jianneng Pan, Hua Wang, Zhaojun Xu, and Bixin Chen.
• Department of Intensive Care Medicine, HwaMei Hospital, University of Chinese Academy of Sciences, Ningbo, Zhejiang 315000, China; Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, Zhejiang 315000, China.
• J Crit Care. 2021 Aug 1; 64: 82-90.

PurposeThis network meta-analysis aims to compare the efficacy and safety of various renal replacement therapy (RRT) modalities in critically ill patients with acute kidney injury (AKI).Materials And MethodsWe searched the electronic databases for randomized controlled trials (RCTs) comparing different RRT modalities, including continuous RRT, intermittent RRT, hybrid RRT, and peritoneal dialysis (PD), in critically ill patients with AKI through July 26, 2020. The primary outcomes were renal recovery and short-term mortality. The study protocol was registered with PROSPERO (CRD42020188115).ResultsTwenty-three studies were included. No difference in the renal recovery or short-term mortality was observed among the four RRT modalities (low certainty). The four RRT modalities had similar effects on the incidence of infectious complications (low certainty). PD was associated with less fluid removal volume and lower incidence of hypotension compared with the extracorporeal modalities, yet no difference in the two outcomes was identified among the extracorporeal modalities (very low to moderate certainty).ConclusionsNo superiority of one particular RRT modality over another in terms of renal recovery and short-term mortality in critically ill patients with AKI. PD exhibited worse fluid removal and better safety in the prevention of hypotension than the extracorporeal modalities.Copyright © 2021 Elsevier Inc. All rights reserved.

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