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The impact of “early” versus “late” initiation of renal replacement therapy in critical care patients with acute kidney injury: a systematic review and evidence synthesis

Overview of attention for article published in Critical Care, May 2016
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  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (95th percentile)
  • High Attention Score compared to outputs of the same age and source (86th percentile)

Mentioned by

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1 blog
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72 X users

Citations

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92 Dimensions

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193 Mendeley
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Title
The impact of “early” versus “late” initiation of renal replacement therapy in critical care patients with acute kidney injury: a systematic review and evidence synthesis
Published in
Critical Care, May 2016
DOI 10.1186/s13054-016-1291-8
Pubmed ID
Authors

Benjamin T. Wierstra, Sameer Kadri, Soha Alomar, Ximena Burbano, Glen W. Barrisford, Raymond L. C. Kao

Abstract

The optimal timing of initiating renal replacement therapy (RRT) in critical illness complicated by acute kidney injury (AKI) is not clearly established. Trials completed on this topic have been marked by contradictory findings as well as quality and heterogeneity issues. Our goal was to perform a synthesis of the evidence regarding the impact of "early" versus "late" RRT in critically ill patients with AKI, focusing on the highest-quality research on this topic. A literature search using the PubMed and Embase databases was completed to identify studies involving critically ill adult patients with AKI who received hemodialysis according to "early" versus "late"/"standard" criteria. The highest-quality studies were selected for meta-analysis. The primary outcome of interest was mortality at 1 month (composite of 28- and 30-day mortality). Secondary outcomes evaluated included intensive care unit (ICU) and hospital length of stay (LOS). Thirty-six studies (seven randomized controlled trials, ten prospective cohorts, and nineteen retrospective cohorts) were identified for detailed evaluation. Nine studies involving 1042 patients were considered to be of high quality and were included for quantitative analysis. No survival advantage was found with "early" RRT among high-quality studies with an OR of 0.665 (95 % CI 0.384-1.153, p = 0.146). Subgroup analysis by reason for ICU admission (surgical/medical) or definition of "early" (time/biochemical) showed no evidence of survival advantage. No significant differences were observed in ICU or hospital LOS among high-quality studies. Our conclusion based on this evidence synthesis is that "early" initiation of RRT in critical illness complicated by AKI does not improve patient survival or confer reductions in ICU or hospital LOS.

X Demographics

X Demographics

The data shown below were collected from the profiles of 72 X users who shared this research output. Click here to find out more about how the information was compiled.
Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 193 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Italy 2 1%
Canada 1 <1%
Unknown 190 98%

Demographic breakdown

Readers by professional status Count As %
Student > Postgraduate 25 13%
Researcher 23 12%
Other 21 11%
Student > Master 18 9%
Student > Ph. D. Student 14 7%
Other 56 29%
Unknown 36 19%
Readers by discipline Count As %
Medicine and Dentistry 124 64%
Nursing and Health Professions 13 7%
Agricultural and Biological Sciences 4 2%
Engineering 4 2%
Biochemistry, Genetics and Molecular Biology 2 1%
Other 10 5%
Unknown 36 19%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 47. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 05 June 2017.
All research outputs
#884,930
of 25,371,288 outputs
Outputs from Critical Care
#670
of 6,554 outputs
Outputs of similar age
#15,462
of 312,371 outputs
Outputs of similar age from Critical Care
#14
of 102 outputs
Altmetric has tracked 25,371,288 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 96th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 6,554 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 20.8. This one has done well, scoring higher than 89% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 312,371 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 95% of its contemporaries.
We're also able to compare this research output to 102 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 86% of its contemporaries.