Unraveling the Complex Benefits and Risks of Renal Replacement Therapy in ICU Patients: Insights from a Japanese Registry

Highlight

• Renal replacement therapy (RRT) was overall associated with higher hospital mortality in critically ill patients, but substantial heterogeneity in treatment effects exists.

• Machine learning methods identified patient subgroups with potential mortality benefit from RRT, particularly those with elevated serum creatinine, reduced urine output, and high blood urea nitrogen levels.

• Patients with relatively preserved renal function experienced potential harm, underscoring the need for more individualized treatment decisions.

• These findings support a data-driven, nuanced approach to optimize RRT initiation strategies in ICU settings.

Study Background