Consensus-Based Recommendations on Priority Activities to Address Acute Kidney Injury in Children: A Modified Delphi Consensus Statement.
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Goldstein Stuart L, Akcan-Arikan Ayse, Alobaidi Rashid, Askenazi David J, Bagshaw Sean M, Barhight Matthew, Barreto Erin, Bayrakci Benan, Bignall Orville N R, Bjornstad Erica, Brophy Patrick D, Chanchlani Rahul, Charlton Jennifer R, Conroy Andrea L, Deep Akash, Devarajan Prasad, Dolan Kristin, Fuhrman Dana Y, Gist Katja M, Gorga Stephen M, Greenberg Jason H, Hasson Denise, Ulrich Emma Heydari, Iyengar Arpana, Jetton Jennifer G, Krawczeski Catherine, Meigs Leslie, Menon Shina, Morgan Jolyn, Morgan Catherine J, Mottes Theresa, Neumayr Tara M, Ricci Zaccaria, Selewski David, Soranno Danielle E, Starr Michelle, Stanski Natalja L, Sutherland Scott M, Symons Jordan, Tavares Marcelo S, Vega Molly Wong, Zappitelli Michael, Ronco Claudio, Mehta Ravindra L, Kellum John, Ostermann Marlies, Basu Rajit K, Pediatric ADQI Collaborative
Аннотация
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.