Ideal determinants for the initiation of renal replacement therapy: timing, metabolic threshold or fluid balance?

Patients with acute kidney injury (AKI) frequently require initiation of renal replacement therapy (RRT). Currently there is considerable variation worldwide on the indications for and timing of initiation and discontinuation of RRT for AKI. Numerous parameters for metabolic, solute and fluid control are generally utilized to guide the initiation and discontinuation of RRT. However, there are currently no standards in this field.