Gembillo G, Floris M, Lo Cicero L, Spadaro G, Soraci L, Santoro D. Slow continuous ultrafiltration and prolonged intermittent renal replacement therapy: Tailoring renal replacement therapy in intensive care unit. World J Nephrol 2026; 15(2): 118219 [DOI: 10.5527/wjn.v15.i2.118219]
Corresponding Author of This Article
Guido Gembillo, MD, PhD, Unit of Nephrology and Dialysis, Department of Clinical and Experimental Medicine, AOU “G. Martino”, University of Messina, Via Consolare Valeria 1, Messina 98125, Italy. guidogembillo@live.it
Research Domain of This Article
Urology & Nephrology
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review-article
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Gembillo G, Floris M, Lo Cicero L, Spadaro G, Soraci L, Santoro D. Slow continuous ultrafiltration and prolonged intermittent renal replacement therapy: Tailoring renal replacement therapy in intensive care unit. World J Nephrol 2026; 15(2): 118219 [DOI: 10.5527/wjn.v15.i2.118219]
World J Nephrol. Jun 25, 2026; 15(2): 118219 Published online Jun 25, 2026. doi: 10.5527/wjn.v15.i2.118219
Slow continuous ultrafiltration and prolonged intermittent renal replacement therapy: Tailoring renal replacement therapy in intensive care unit
Guido Gembillo, Matteo Floris, Lorenzo Lo Cicero, Giuseppe Spadaro, Luca Soraci, Domenico Santoro
Guido Gembillo, Lorenzo Lo Cicero, Giuseppe Spadaro, Domenico Santoro, Unit of Nephrology and Dialysis, Department of Clinical and Experimental Medicine, AOU “G. Martino”, University of Messina, Messina 98125, Italy
Matteo Floris, Department of Nephrology and Dialysis, G. Brotzu Hospital, Cagliari 09121, Sardegna, Italy
Luca Soraci, Unit of Geriatric Medicine, Italian National Research Center on Aging (IRCCS INRCA), Cosenza 87100, Calabria, Italy
Author contributions: Gembillo G and Santoro D conceived and designed the review; Gembillo G supervised the project and coordinated the writing process; Floris M, Spadaro G, and Lo Cicero L performed the literature search and data extraction; Santoro D, Soraci L, and Gembillo G critically appraised the literature and contributed to data interpretation; Gembillo G, Santoro D, and Soraci L drafted the main sections of the manuscript. All authors revised the manuscript critically for important intellectual content and approved the final version.
AI contribution statement: AI tools were only used for language polishing and editorial refinement (grammar, syntax, lexical clarity, and stylistic consistency in English) of text originally written by the authors. Specifically, Nature Research Assistant and Claude were used to refine grammar, improve readability, and ensure linguistic consistency throughout the manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Guido Gembillo, MD, PhD, Unit of Nephrology and Dialysis, Department of Clinical and Experimental Medicine, AOU “G. Martino”, University of Messina, Via Consolare Valeria 1, Messina 98125, Italy. guidogembillo@live.it
Received: December 28, 2025 Revised: January 27, 2026 Accepted: March 5, 2026 Published online: June 25, 2026 Processing time: 170 Days and 18.3 Hours
Core Tip
Core Tip: Acute kidney injury in intensive care settings requires more than choosing a dialysis modality. An overall understanding of each patient’s fragility, priorities, and capacity for recovery is needed. Slow continuous ultrafiltration offers gentle decongestion for those burdened by volume overload, while prolonged intermittent renal replacement therapy provides steady support that preserves hemodynamic tolerance and allows meaningful time off therapy. Continuous treatments are essential when instability leaves no room for abrupt physiologic shifts. The central insight is that renal-replacement therapy succeeds when tailored to the patient’s evolving physiology, transforming a technical intervention into truly individualized organ support.
