Severe acute kidney injury usually requires renal replacement therapy. Intermittent hemodialysis, peritoneal dialysis, continuous renal replacement therapy, and prolonged intermittent renal replacement therapy are the four common modalities of renal replacement therapy. Whether one modality of renal replacement therapy is superior to another in clinical practice remains controversial. The impact of the choice of renal replacement therapy modality on the short-term and long-term prognosis of patients needs to be further explored in large-scale randomized controlled studies and a longer follow-up time. This article will discuss the development history of renal replacement therapy for acute kidney injury, the current status of its application, and the comparison of the four treatment modalities, in order to help clinicians have a deeper understanding of how to design individualized renal replacement therapy programs for patients with acute kidney injury under the guidance of the concept of precision medicine.