What this means
Researchers looked at 20 studies comparing setups for kidney treatment during ECMO. No setup clearly worked better than the others. More careful studies are needed before doctors can agree on the best approach.
Plain-English summary written by an AI model from the abstract. The original is below.
- Who it was tested in
- 20 studies: 12 clinical, 3 in cells in a lab, 1 computer model, 4 surveys
- Kind of research
- A summary of earlier studies
The science
- Original title
- Comparison of the approaches to combine Renal Replacement Therapy with Extracorporeal Membrane Oxygenation - a Scoping Review.
- Authors
- Kharrouba E, Moyon Q, Cove ME et al.
- Journal
- Annals of intensive care
- Published
- Oct 13, 2026
- Study type
- Review
- PMID
- 42866594 ↗
Abstract
Background
Extracorporeal membrane oxygenation (ECMO) is increasingly used for cardiac and respiratory failure and is associated with high rates of acute kidney injury (AKI) and fluid overload requiring renal replacement therapy (RRT). ECMO and RRT can be run independently in parallel, or RRT hemofilter or device can be integrated into the ECMO circuit. Several parallel and integrated ECMO-RRT configurations have been described, but the optimal approach remains uncertain.This scoping review mapped the available literature comparing at least two ECMO-RRT configurations, summarized reported outcomes, and identified knowledge gaps.
What they did
We searched PubMed, Cochrane Library, Web of Science, Embase, and ClinicalTrials.gov without restrictions, with the final search conducted on February 9, 2026. Eligible studies compared at least 2 ECMO-RRT configurations linked to reported outcomes. Data on study characteristics, configurations, outcomes, and anticoagulation were extracted and synthesized.
What they found
Of 6,806 records, 20 studies were included: 12 were clinical including 1 randomized controlled trial, 3 in vitro, 1 in silico, and 4 surveys. More than 8 ECMO-RRT connection schemes have been described by clinical studies since 2013. No consistent differences in efficiency or clinical outcomes were observed between the configurations compared. Integrated methods were associated with longer or comparable hemofilter lifespan. Surveys confirmed heterogeneous medical practices, and 2 safety concerns (unstoppable pressure alarms and air embolism) were reported. Evidence on ECMO-RRT configurations is limited and heterogeneous. Future systematic and rigorous comparison of all the configurations through preclinical and clinical studies is needed to harmonize medical practices and inform the development of guidelines.
The authors' abstract, grouped under plain headings from its own section labels.
Kharrouba E, Moyon Q, Cove ME et al. Comparison of the approaches to combine Renal Replacement Therapy with Extracorporeal Membrane Oxygenation - a Scoping Review. Annals of intensive care. 2026. doi:10.1016/j.aicoj.2026.100165. PMID: 42866594. https://pubmed.ncbi.nlm.nih.gov/42866594/