Aim of the work this study aimed to evaluate the impact of early versus late initiation of continuous renal replacement therapy on clinical outcomes in critically ill patients with AKI. Results regarding our retrospective cohort study and after prolonged exhaustive analysis of all the related data, some variables were found to be significantly related to the outcome of these critical ICU patients. These variables were systolic BP, WBCs, albumin, magnesium, PTT and INR at the start of CRRT. Some patients with AKI were associated with sepsis; there was a little benefit of early CRRT, in terms of ICU mortality. This needs further clarification by larger and high-powered studies. Conclusion finally, the decision for early or late CRRT, in patients with AKI, should be individualized according to the clinical and laboratory parameters of each patient. It should also include the opinion of senior nephrologists, experienced in management of AKI. The decision should be sensitively communicated to the patients and/or their relatives, explaining the actual role of CRRT in management of their critical disorder.