ECB-ART-52122
JAMA Netw Open
2022 Sep 01;59:e2229442. doi: 10.1001/jamanetworkopen.2022.29442.
Show Gene links
Show Anatomy links
Consensus-Based Recommendations on Priority Activities to Address Acute Kidney Injury in Children: A Modified Delphi Consensus Statement.
Goldstein SL
,
Akcan-Arikan A
,
Alobaidi R
,
Askenazi DJ
,
Bagshaw SM
,
Barhight M
,
Barreto E
,
Bayrakci B
,
Bignall ONR
,
Bjornstad E
,
Brophy PD
,
Chanchlani R
,
Charlton JR
,
Conroy AL
,
Deep A
,
Devarajan P
,
Dolan K
,
Fuhrman DY
,
Gist KM
,
Gorga SM
,
Greenberg JH
,
Hasson D
,
Ulrich EH
,
Iyengar A
,
Jetton JG
,
Krawczeski C
,
Meigs L
,
Menon S
,
Morgan J
,
Morgan CJ
,
Mottes T
,
Neumayr TM
,
Ricci Z
,
Selewski D
,
Soranno DE
,
Starr M
,
Stanski NL
,
Sutherland SM
,
Symons J
,
Tavares MS
,
Vega MW
,
Zappitelli M
,
Ronco C
,
Mehta RL
,
Kellum J
,
Ostermann M
,
Basu RK
,
Pediatric ADQI Collaborative
.
Abstract
IMPORTANCE: Increasing evidence indicates that acute kidney injury (AKI) occurs frequently in children and young adults and is associated with poor short-term and long-term outcomes. Guidance is required to focus efforts related to expansion of pediatric AKI knowledge. OBJECTIVE: To develop expert-driven pediatric specific recommendations on needed AKI research, education, practice, and advocacy. EVIDENCE REVIEW: At the 26th Acute Disease Quality Initiative meeting conducted in November 2021 by 47 multiprofessional international experts in general pediatrics, nephrology, and critical care, the panel focused on 6 areas: (1) epidemiology; (2) diagnostics; (3) fluid overload; (4) kidney support therapies; (5) biology, pharmacology, and nutrition; and (6) education and advocacy. An objective scientific review and distillation of literature through September 2021 was performed of (1) epidemiology, (2) risk assessment and diagnosis, (3) fluid assessment, (4) kidney support and extracorporeal therapies, (5) pathobiology, nutrition, and pharmacology, and (6) education and advocacy. Using an established modified Delphi process based on existing data, workgroups derived consensus statements with recommendations. FINDINGS: The meeting developed 12 consensus statements and 29 research recommendations. Principal suggestions were to address gaps of knowledge by including data from varying socioeconomic groups, broadening definition of AKI phenotypes, adjudicating fluid balance by disease severity, integrating biopathology of child growth and development, and partnering with families and communities in AKI advocacy. CONCLUSIONS AND RELEVANCE: Existing evidence across observational study supports further efforts to increase knowledge related to AKI in childhood. Significant gaps of knowledge may be addressed by focused efforts.
PubMed ID: 36178697
Article link: JAMA Netw Open
Grant support: [+]
References [+] :
Abbasi,
Discriminatory Precision of Renal Angina Index in Predicting Acute Kidney Injury in Children; a Systematic Review and Meta-Analysis.
2020, Pubmed
Abbasi, Discriminatory Precision of Renal Angina Index in Predicting Acute Kidney Injury in Children; a Systematic Review and Meta-Analysis. 2020, Pubmed
Abraham, Protein energy wasting in children with chronic kidney disease. 2014, Pubmed
Akcan-Arikan, Fluid Overload and Kidney Injury Score: A Multidimensional Real-Time Assessment of Renal Disease Burden in the Critically Ill Patient. 2017, Pubmed
Akcan-Arikan, Modified RIFLE criteria in critically ill children with acute kidney injury. 2007, Pubmed
Alobaidi, Fluid Accumulation in Critically Ill Children. 2020, Pubmed
Askenazi, Fluid overload and mortality are associated with acute kidney injury in sick near-term/term neonate. 2013, Pubmed
Askenazi, Kidney support therapy in the pediatric patient: Unique considerations for a unique population. 2021, Pubmed
Askenazi, Strategies to improve the understanding of long-term renal consequences after neonatal acute kidney injury. 2016, Pubmed
Bairey Merz, Sex and the kidneys: current understanding and research opportunities. 2019, Pubmed
Barhight, Increase in chloride from baseline is independently associated with mortality in critically ill children. 2018, Pubmed
Barhight, Effects of hyperchloremia on renal recovery in critically ill children with acute kidney injury. 2020, Pubmed
Barnes-Daly, Improving Hospital Survival and Reducing Brain Dysfunction at Seven California Community Hospitals: Implementing PAD Guidelines Via the ABCDEF Bundle in 6,064 Patients. 2017, Pubmed
Basu, Combining functional and tubular damage biomarkers improves diagnostic precision for acute kidney injury after cardiac surgery. 2014, Pubmed
Basu, Clinical phenotypes of acute kidney injury are associated with unique outcomes in critically ill septic children. 2021, Pubmed
Bellomo, Acute renal failure - definition, outcome measures, animal models, fluid therapy and information technology needs: the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group. 2004, Pubmed
Bennett, Preoperative levels of urinary uromodulin predict acute kidney injury after pediatric cardiopulmonary bypass surgery. 2018, Pubmed
Bjornstad, Racial and health insurance disparities in pediatric acute kidney injury in the USA. 2020, Pubmed
Blinder, Acute Kidney Injury After Pediatric Cardiac Surgery: A Secondary Analysis of the Safe Pediatric Euglycemia After Cardiac Surgery Trial. 2017, Pubmed
Blinder, Congenital heart surgery in infants: effects of acute kidney injury on outcomes. 2012, Pubmed
Bontant, Assessing fluid balance in critically ill pediatric patients. 2015, Pubmed
Borasino, Furosemide Response Predicts Acute Kidney Injury After Cardiac Surgery in Infants and Neonates. 2018, Pubmed
Castillo, Nutritional status and clinical outcome of children on continuous renal replacement therapy: a prospective observational study. 2012, Pubmed
Charlton, Nephron number and its determinants: a 2020 update. 2021, Pubmed
Chawla, Acute kidney disease and renal recovery: consensus report of the Acute Disease Quality Initiative (ADQI) 16 Workgroup. 2017, Pubmed
Colbert, The Social Media Revolution in Nephrology Education. 2018, Pubmed
Finkelstein, Peritoneal dialysis, acute kidney injury, and the Saving Young Lives program. 2014, Pubmed
Fitzgerald, Acute Kidney Injury in Pediatric Severe Sepsis: An Independent Risk Factor for Death and New Disability. 2016, Pubmed
Fleming, The Incidence of Acute Kidney Injury and Its Effect on Neonatal and Pediatric Extracorporeal Membrane Oxygenation Outcomes: A Multicenter Report From the Kidney Intervention During Extracorporeal Membrane Oxygenation Study Group. 2016, Pubmed
Foland, Fluid overload before continuous hemofiltration and survival in critically ill children: a retrospective analysis. 2004, Pubmed
Fröhlich, Use of 2-hour creatinine clearance to guide cessation of continuous renal replacement therapy. 2012, Pubmed
Fuhrman, Baseline tubular biomarkers in young adults with congenital heart disease as compared to healthy young adults: Detecting subclinical kidney injury. 2019, Pubmed
Gist, Kinetics of the cell cycle arrest biomarkers (TIMP-2*IGFBP-7) for prediction of acute kidney injury in infants after cardiac surgery. 2017, Pubmed
Gist, Transient and persistent acute kidney injury phenotypes following the Norwood operation: a retrospective study. 2022, Pubmed
Gist, Assessment of the Independent and Synergistic Effects of Fluid Overload and Acute Kidney Injury on Outcomes of Critically Ill Children. 2020, Pubmed
Goldstein, Survival of infants treated with CKRT: comparing adapted adult platforms with the Carpediem™. 2022, Pubmed
Goldstein, Outcome in children receiving continuous venovenous hemofiltration. 2001, Pubmed
Goldstein, Pediatric patients with multi-organ dysfunction syndrome receiving continuous renal replacement therapy. 2005, Pubmed
Gorga, Fluid overload and fluid removal in pediatric patients on extracorporeal membrane oxygenation requiring continuous renal replacement therapy: a multicenter retrospective cohort study. 2020, Pubmed
Greenberg, Kidney Outcomes 5 Years After Pediatric Cardiac Surgery: The TRIBE-AKI Study. 2016, Pubmed
Haase, The outcome of neutrophil gelatinase-associated lipocalin-positive subclinical acute kidney injury: a multicenter pooled analysis of prospective studies. 2011, Pubmed
Harel, Nephrologist follow-up improves all-cause mortality of severe acute kidney injury survivors. 2013, Pubmed
Harer, Improving the quality of neonatal acute kidney injury care: neonatal-specific response to the 22nd Acute Disease Quality Initiative (ADQI) conference. 2021, Pubmed
Hassinger, Early postoperative fluid overload precedes acute kidney injury and is associated with higher morbidity in pediatric cardiac surgery patients. 2014, Pubmed
Hayes, Outcomes of critically ill children requiring continuous renal replacement therapy. 2009, Pubmed
Hazle, Fluid overload in infants following congenital heart surgery. 2013, Pubmed
Hessey, Healthcare Utilization after Acute Kidney Injury in the Pediatric Intensive Care Unit. 2018, Pubmed
Hessey, Acute Kidney Injury in Critically Ill Children and Subsequent Chronic Kidney Disease. 2019, Pubmed
Hessey, Acute Kidney Injury in Critically Ill Children Is Not all Acute: Lessons Over the Last 5 Years. 2021, Pubmed
Hodgson, The Role of Risk Prediction Models in Prevention and Management of AKI. 2019, Pubmed
Hopkins, Transforming PICU Culture to Facilitate Early Rehabilitation. 2015, Pubmed
Hoste, Four phases of intravenous fluid therapy: a conceptual model. 2014, Pubmed
Hukriede, Experimental models of acute kidney injury for translational research. 2022, Pubmed
Husain-Syed, Preoperative Renal Functional Reserve Predicts Risk of Acute Kidney Injury After Cardiac Operation. 2018, Pubmed
Jetton, Incidence and outcomes of neonatal acute kidney injury (AWAKEN): a multicentre, multinational, observational cohort study. 2017, Pubmed
Kaddourah, Epidemiology of Acute Kidney Injury in Critically Ill Children and Young Adults. 2017, Pubmed
Kaddourah, Oliguria and Acute Kidney Injury in Critically Ill Children: Implications for Diagnosis and Outcomes. 2019, Pubmed
Kashani, Quality Improvement Goals for Acute Kidney Injury. 2019, Pubmed
Lebel, Long-term complications of acute kidney injury in children. 2020, Pubmed
Li, Early fluid overload is associated with acute kidney injury and PICU mortality in critically ill children. 2016, Pubmed
Lima, Timing of Fluid Overload and Association With Patient Outcome. 2021, Pubmed
Lion, The effect of continuous venovenous hemodiafiltration on amino acid delivery, clearance, and removal in children. 2022, Pubmed
Liu, AKI!Now Initiative: Recommendations for Awareness, Recognition, and Management of AKI. 2020, Pubmed
Lombel, Implications of different fluid overload definitions in pediatric stem cell transplant patients requiring continuous renal replacement therapy. 2012, Pubmed
Lunyera, Acute Kidney Injury in Low-Resource Settings: Barriers to Diagnosis, Awareness, and Treatment and Strategies to Overcome These Barriers. 2016, Pubmed
Macedo, Recognition and management of acute kidney injury in children: The ISN 0by25 Global Snapshot study. 2018, Pubmed
Macedo, Recognition and management of community-acquired acute kidney injury in low-resource settings in the ISN 0by25 trial: A multi-country feasibility study. 2021, Pubmed
Madsen, Cardiac surgery in patients with congenital heart disease is associated with acute kidney injury and the risk of chronic kidney disease. 2017, Pubmed
Malagaris, Determinants of skeletal muscle protein turnover following severe burn trauma in children. 2019, Pubmed
Mallory, Acute Kidney Injury, Fluid Overload, and Outcomes in Children Supported With Extracorporeal Membrane Oxygenation for a Respiratory Indication. 2020, Pubmed
McCullough, Implementation of novel biomarkers in the diagnosis, prognosis, and management of acute kidney injury: executive summary from the tenth consensus conference of the Acute Dialysis Quality Initiative (ADQI). 2013, Pubmed
McGregor, Acute Kidney Injury Incidence in Noncritically Ill Hospitalized Children, Adolescents, and Young Adults: A Retrospective Observational Study. 2016, Pubmed
Meersch, Prevention of cardiac surgery-associated AKI by implementing the KDIGO guidelines in high risk patients identified by biomarkers: the PrevAKI randomized controlled trial. 2017, Pubmed
Mehta, Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury. 2007, Pubmed
Menon, Urinary biomarker incorporation into the renal angina index early in intensive care unit admission optimizes acute kidney injury prediction in critically ill children: a prospective cohort study. 2016, Pubmed
Menon, Acute kidney injury associated with high nephrotoxic medication exposure leads to chronic kidney disease after 6 months. 2014, Pubmed
Michael, Fluid overload and acute renal failure in pediatric stem cell transplant patients. 2004, Pubmed
Mottes, Process based quality improvement using a continuous renal replacement therapy dashboard. 2019, Pubmed
Mottes, Does Your Program Know Its AKI and CRRT Epidemiology? The Case for a Dashboard. 2020, Pubmed
Mottes, Improving delivery of continuous renal replacement therapy: impact of a simulation-based educational intervention. 2013, Pubmed
Neyra, Improving the quality of care for patients requiring continuous renal replacement therapy. 2021, Pubmed
Nguyen, Selective Serotonin Reuptake Inhibitor Pharmaco-Omics: Mechanisms and Prediction. 2020, Pubmed
Parikh, Postoperative biomarkers predict acute kidney injury and poor outcomes after adult cardiac surgery. 2011, Pubmed
Penk, Furosemide response predicts acute kidney injury in children after cardiac surgery. 2019, Pubmed
Przybyl, Using High-Fidelity Simulation to Assess Knowledge, Skills, and Attitudes in Nurses Performing CRRT. 2015, Pubmed
Pun, Caring for Critically Ill Patients with the ABCDEF Bundle: Results of the ICU Liberation Collaborative in Over 15,000 Adults. 2019, Pubmed
Rees, Protein energy wasting; what is it and what can we do to prevent it? 2021, Pubmed
Rewa, Quality of care and safety measures of acute renal replacement therapy: Workgroup statements from the 22nd acute disease quality initiative (ADQI) consensus conference. 2019, Pubmed
Rewa, Quality indicators in continuous renal replacement therapy (CRRT) care in critically ill patients: protocol for a systematic review. 2015, Pubmed
Rewa, A modified Delphi process to identify, rank and prioritize quality indicators for continuous renal replacement therapy (CRRT) care in critically ill patients. 2018, Pubmed
Richardson, Nursing essential principles: continuous renal replacement therapy. 2015, Pubmed
Robinson, Long-Term Kidney Outcomes Following Dialysis-Treated Childhood Acute Kidney Injury: A Population-Based Cohort Study. 2021, Pubmed
Rodieux, Effect of Kidney Function on Drug Kinetics and Dosing in Neonates, Infants, and Children. 2015, Pubmed
Ruiz, Development, implementation and outcomes of a quality assurance system for the provision of continuous renal replacement therapy in the intensive care unit. 2020, Pubmed
Sandokji, A Time-Updated, Parsimonious Model to Predict AKI in Hospitalized Children. 2020, Pubmed
Sato, Pathophysiology of AKI to CKD progression. 2020, Pubmed
Schiffl, Current Approach to Successful Liberation from Renal Replacement Therapy in Critically Ill Patients with Severe Acute Kidney Injury: The Quest for Biomarkers Continues. 2021, Pubmed
Schmidt, Indomethacin prophylaxis, patent ductus arteriosus, and the risk of bronchopulmonary dysplasia: further analyses from the Trial of Indomethacin Prophylaxis in Preterms (TIPP). 2006, Pubmed
Schunk, Association between urinary dickkopf-3, acute kidney injury, and subsequent loss of kidney function in patients undergoing cardiac surgery: an observational cohort study. 2019, Pubmed
Selewski, Quality improvement goals for pediatric acute kidney injury: pediatric applications of the 22nd Acute Disease Quality Initiative (ADQI) conference. 2021, Pubmed
Selewski, Fluid overload and fluid removal in pediatric patients on extracorporeal membrane oxygenation requiring continuous renal replacement therapy. 2012, Pubmed
Selewski, Weight-based determination of fluid overload status and mortality in pediatric intensive care unit patients requiring continuous renal replacement therapy. 2011, Pubmed
Selewski, The Impact of Fluid Overload on Outcomes in Children Treated With Extracorporeal Membrane Oxygenation: A Multicenter Retrospective Cohort Study. 2017, Pubmed
Selewski, The impact of fluid balance on outcomes in premature neonates: a report from the AWAKEN study group. 2020, Pubmed
Selewski, The impact of fluid balance on outcomes in critically ill near-term/term neonates: a report from the AWAKEN study group. 2019, Pubmed
Selewski, Is acute kidney injury a harbinger for chronic kidney disease? 2018, Pubmed
Shen, Continuous Renal Replacement Therapy Quality Control and Performance Measures. 2018, Pubmed
Silver, Ambulatory care after acute kidney injury: an opportunity to improve patient outcomes. 2015, Pubmed
Sinitsky, Fluid overload at 48 hours is associated with respiratory morbidity but not mortality in a general PICU: retrospective cohort study. 2015, Pubmed
Smith, Patient-centered outcomes in pediatric continuous kidney replacement therapy: new morbidity and worsened functional status in survivors. 2022, Pubmed
Stanski, Integration of urinary neutrophil gelatinase-associated lipocalin with serum creatinine delineates acute kidney injury phenotypes in critically ill children. 2019, Pubmed
Starr, Advances in Neonatal Acute Kidney Injury. 2021, Pubmed
Starr, Prematurity and future kidney health: the growing risk of chronic kidney disease. 2018, Pubmed
Sutherland, AKI in hospitalized children: epidemiology and clinical associations in a national cohort. 2013, Pubmed
Sutherland, AKI in hospitalized children: comparing the pRIFLE, AKIN, and KDIGO definitions. 2015, Pubmed
Sutherland, Cumulative Application of Creatinine and Urine Output Staging Optimizes the Kidney Disease: Improving Global Outcomes Definition and Identifies Increased Mortality Risk in Hospitalized Patients With Acute Kidney Injury. 2021, Pubmed
Sutherland, Fluid overload and mortality in children receiving continuous renal replacement therapy: the prospective pediatric continuous renal replacement therapy registry. 2010, Pubmed
Uber, Nephrotoxin exposure and acute kidney injury in critically ill children undergoing congenital cardiac surgery. 2018, Pubmed
Uchino, Discontinuation of continuous renal replacement therapy: a post hoc analysis of a prospective multicenter observational study. 2009, Pubmed
Valentine, Fluid balance in critically ill children with acute lung injury. 2012, Pubmed
Vega, Quality Improvement Bedside Rounding Audits Enhance Protein Provision for Pediatric Patients Receiving Continuous Renal Replacement Therapy. 2018, Pubmed
Verbruggen, Albumin synthesis rates in post-surgical infants and septic adolescents; influence of amino acids, energy, and insulin. 2011, Pubmed
Zappitelli, Acute kidney injury in non-critically ill children treated with aminoglycoside antibiotics in a tertiary healthcare centre: a retrospective cohort study. 2011, Pubmed
van Asperen, Reliability of the fluid balance in neonates. 2012, Pubmed