Timing of dialysis There is no uniform rule or standard for when to start renal replacement therapy in patients with AKI. The timing of PD therapy is determined by the patient’s own status, such as the primary cause, residual urine output, degree of azotemia, and the rate of catabolism, rather than by blood urea and creatinine values alone. From a clinical point of view, the earlier the renal replacement therapy is administered, the more rapidly the adverse effects of AKI can be alleviated and, crucially, the more effective it is in preventing or delaying the onset of AKI comorbidities. Recently, it has been reported in the literature that early high-dose PD therapy not only results in significantly lower mortality but also faster recovery of renal function than late dialysis patients. When choosing a PD regimen, a reasonable dose of PD is critical to the successful treatment of AKI. Due to the complex etiology of AKI, some patients may have multiple organ injuries combined, when hemodynamic instability is extremely high, followed by the prevalence of hypercatabolic states and other comorbidities, it is difficult to determine a reasonable dialysate dose from clinical signs or biochemical indicators. Insufficient dialysis dose can hardly relieve the patient’s condition; while excessive dialysis will not only fail to play a therapeutic role, but also increase the loss of protein and other nutrients in the body, induce other comorbidities and accelerate the deterioration of the condition. Therefore, when determining the dialysis dose, the number and degree of damaged organs as well as the changes in the patient’s daily metabolism, effective circulating volume and blood biochemistry should be taken into consideration. In other words, the dialysis fluid dose should be proportional to the severity of the disease, the number of damaged organs and the high or low catabolic state. In short, the ideal dialysis dose is the one that can maintain the metabolism and circulatory volume of the patient’s body in a relatively stable state. It has been found that for patients with moderate AKI, treatment volume correlates with prognosis, and patients with above-average dialysis volume (Kt/Vurea>1) have a higher survival rate. In contrast, for patients with critical or mild disease, dialysis dose did not correlate with prognosis.