©Author(s) (or their employer(s)) 2026. No commercial re-use. See Permissions. Published by Baishideng Publishing Group Inc.
World J Crit Care Med. Mar 9, 2026; 15(1): 110552
Published online Mar 9, 2026. doi: 10.5492/wjccm.v15.i1.110552
Published online Mar 9, 2026. doi: 10.5492/wjccm.v15.i1.110552
Continuous renal replacement therapy in acute liver failure
Caleb Fisher, Stephen Warrillow, Department of Critical Care, The University of Melbourne, Parkville 3010, Victoria, Australia
Caleb Fisher, Stephen Warrillow, Department of Intensive Care, Austin Health, Heidelberg 3084, Victoria, Australia
Stephen Warrillow, Critical Care Institute, Epworth Health Care, Richmond 3121, Victoria, Australia
Author contributions: Fisher C and Warrillow S conceived the original concept, contributed equally to the initial draft, developed subsequent drafts, and revised the manuscript based on reviewer feedback; and all authors thoroughly reviewed and endorsed the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Stephen Warrillow, PhD, Associate Professor, Department of Intensive Care, Austin Health, 145 Studley Road, Heidelberg 3084, Victoria, Australia.
Received: June 10, 2025
Revised: August 19, 2025
Accepted: November 14, 2025
Published online: March 9, 2026
Processing time: 264 Days and 18.4 Hours
Revised: August 19, 2025
Accepted: November 14, 2025
Published online: March 9, 2026
Processing time: 264 Days and 18.4 Hours
Core Tip
Core Tip: The early initiation of continuous renal replacement therapy in patients admitted to the intensive care unit with acute liver failure is safe and provides a range of benefits that are likely neuroprotective. These include control of hyperammonaemia, prevention of fever, control of acidaemia, control of fluid balance and control of electrolyte derangement. Continuous renal replacement therapy can be started in all acute liver failure patients intubated for hepatic encephalopathy and should not be delayed until evidence of renal failure becomes apparent.