{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T13:12:11Z","timestamp":1781874731840,"version":"3.54.5"},"reference-count":41,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T00:00:00Z","timestamp":1768780800000},"content-version":"vor","delay-in-days":18,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Science Reports"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Extracorporeal membrane oxygenation (ECMO) is a life\u2010saving intervention for refractory cardiopulmonary failure. Despite advancements reducing complications, ECMO remains associated with acute kidney injury (AKI), often requiring kidney replacement therapy (KRT). Studies report up to 45% of ECMO patients needing KRT, significantly increasing mortality. A prior meta\u2010analysis suggested a declining mortality trend in recent years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methodology<\/jats:title>\n                    <jats:p>Following PRISMA guidelines, PubMed, MEDLINE, EMBASE, and Cochrane Library were searched (2000\u20132024) for randomized and observational studies on adult ECMO patients requiring KRT. Data extraction covered study characteristics, patient demographics, ECMO type, KRT timing, and clinical outcomes. Quality was assessed using the Newcastle\u2013Ottawa Scale. Statistical analyses were performed using RevMan 5.4.1 under a random\u2010effects model, with mortality as the primary outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Result<\/jats:title>\n                    <jats:p>\n                      A total of 24 studies (6347 patients) met the inclusion criteria, including 23 observational studies and one RCT. The mean age of ECMO\u2009+\u2009KRT patients was 51 years in observational studies and 61.2 years in the RCT, with cardiogenic shock as the most common ECMO indication. Meta\u2010analysis showed a significantly higher mortality in ECMO\u2009+\u2009KRT patients (RR: 1.86, 95% CI: 1.63\u20132.12,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), with infections and bleeding as key contributors. Subgroup analysis revealed no significant survival difference based on KRT timing, while Veno\u2010arterial extracorporeal membrane oxygenation (VA\u2010ECMO) was associated with worse outcomes than Veno\u2010venous extracorporeal membrane oxygenation (VV\u2010ECMO). The RCT reported 61.9% mortality at 30 days in ECMO\u2009+\u2009KRT patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>KRT during ECMO is associated with increased mortality, likely due to the severity of illness and complications like infections and bleeding. The optimal timing of KRT initiation remains unclear, and no significant survival benefit was found for early KRT. Further large\u2010scale RCTs are needed to optimize management strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hsr2.71742","type":"journal-article","created":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T07:49:38Z","timestamp":1768895378000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Impact of Kidney Replacement Therapy During Extracorporeal Membrane Oxygenation Support in Terms of Mortality: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2695-8714","authenticated-orcid":false,"given":"Ranjit","family":"Sah","sequence":"first","affiliation":[{"name":"Department of Internal Medicine BMC South, BMC Health System  Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amita","family":"Paudel","sequence":"additional","affiliation":[{"name":"Kathmandu University School of Medical Science Dhulikhel Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8203-3329","authenticated-orcid":false,"given":"Sangam","family":"Shah","sequence":"additional","affiliation":[{"name":"Institute of Medicine, Tribhuvan University Maharajgunj Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6382-1082","authenticated-orcid":false,"given":"Madhur","family":"Bhattarai","sequence":"additional","affiliation":[{"name":"Institute of Medicine, Tribhuvan University Maharajgunj Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-8767-4240","authenticated-orcid":false,"given":"Sujata","family":"Bhandari","sequence":"additional","affiliation":[{"name":"Nobel Medical College Biratnagar Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bishwa Raj","family":"Adhikari","sequence":"additional","affiliation":[{"name":"Institute of Medicine, Tribhuvan University Maharajgunj Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjit","family":"Sah","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed\u2010to\u2010be\u2010University) Pimpri, Pune Maharashtra India"},{"name":"Department of Public Health Dentistry Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth (Deemed\u2010to\u2010be\u2010University) Pune Maharashtra India"},{"name":"Department of Medicine Korea Universtiy Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4771-4089","authenticated-orcid":false,"given":"Rachana","family":"Mehta","sequence":"additional","affiliation":[{"name":"SR Sanjeevani Hospital Kalyanpur Siraha Nepal"},{"name":"Department of Clinical Microbiology Manav Rachana University Faridabad Haryana India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anirban","family":"Bhattacharyya","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine Mayo Clinic Jacksonville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pablo Moreno","family":"Franco","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine Mayo Clinic Jacksonville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pramod","family":"Guru","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine Mayo Clinic Jacksonville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjay","family":"Chaudhary","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine Mayo Clinic Jacksonville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,1,19]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1441-2772(23)02009-4"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAT.0000000000001344"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197203232861210"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1979.03300200023016"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.9148"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hlc.2013.08.009"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm8070981"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1081\/JDI-120018719"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10020241"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000100"},{"key":"e_1_2_11_12_1","unstructured":"Green. \u201cCochrane Handbook for Systematic Reviews of\u2026 \u2010 Google Scholar \u201dhttps:\/\/scholar.google.com\/scholar_lookup?title=Cochrane+Handbook+for+Systematic+Reviews+of+Interventions&author=S.+Green&publication_year=2019&."},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471\u20102288\u201014\u201045"},{"key":"e_1_2_11_14_1","unstructured":"J. M.Gierisch C.Beadles A.Shapiro et al. \u201cNewcastle\u2010Ottawa scale coding manual for cohort studies. In: Health Disparities in Quality Indicators of Healthcare Among Adults With Mental Illness \u201d (Department of Veterans Affairs (US) 2014) https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK299087\/."},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l4898"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e31816f7cf7"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1510\/icvts.2008.197681"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.jvca.2010.03.020"},{"issue":"2","key":"e_1_2_11_19_1","first-page":"334","article-title":"Acute Kidney Injury in Adult Postcardiotomy Patients With Extracorporeal Membrane Oxygenation: Evaluation of the RIFLE Classification and the Acute Kidney Injury Network Criteria","volume":"37","author":"Yan X.","year":"2010","journal-title":"European Journal of Cardio\u2010Thoracic Surgery"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfs398"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00595-012-0322-6"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-014-3360-2"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000001141"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/aor.12695"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1177\/0267659117693075"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0203643"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1177\/0267659118755272"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0212352"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ccm.0000645504.46781.dc"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAT.0000000000001210"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1177\/1751143719862240"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1177\/0391398819868483"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1177\/0391398820980451"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1177\/0267659119890214"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.jvca.2021.12.027"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2022.1027586"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13613-022-01046-0"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.jvca.2019.02.031"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.5301\/ijao.5000381"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800840707"},{"key":"e_1_2_11_41_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.semperi.2013.11.002"},{"key":"e_1_2_11_42_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.12731211"}],"container-title":["Health Science Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hsr2.71742","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/hsr2.71742","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hsr2.71742","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T11:20:50Z","timestamp":1771240850000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/hsr2.71742"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":41,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1002\/hsr2.71742"],"URL":"https:\/\/doi.org\/10.1002\/hsr2.71742","archive":["Portico"],"relation":{},"ISSN":["2398-8835","2398-8835"],"issn-type":[{"value":"2398-8835","type":"print"},{"value":"2398-8835","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2025-08-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-03","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-19","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e71742"}}