Initiation criteria of continuous kidney replacement therapy in Japanese Surviving Sepsis 
Campaign Guideline：From 2020 to 2024

Abstract

In recent years, research on acute kidney injury (AKI) and kidney replacement therapy (KRT) has advanced significantly. This article examines the recommendations for the timing of KRT initiation in the Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock (J-SSCG) 2020．Notably, the guidelines include a recommendation for KRT initiation timing, which is divided into two based on severity. The first part does not provide specific recommendations regarding AKI Stage 2, whereas the second part advises against early KRT initiation in AKI Stage 3．The reason for this disparity is that the referenced randomized controlled trials had different patient backgrounds and study designs. The J-SSCG guidelines are revised every four years, and future iterations are expected to include further advancements in AKI management.