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To compare different modalities of renal replacement therapy in critically ill adults with acute kidney injury. We searched Medline, PubMed, Embase, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov from inception to 25 May, 2020. We included randomized controlled trials comparing the efficacy and safety of different renal replacement therapy modalities in critically ill patients with acute kidney injury. Ten reviewers (working in pairs) independently screened studies for eligibility, extracted data, and assessed r