Consensus-Based Recommendations on Priority Activities to Address Acute Kidney Injury in Children A Modified Delphi Consensus Statement

被引：96

作者：

Goldstein, Stuart L. ^{[1
]}

Akcan-Arikan, Ayse ^{[2
]}

Alobaidi, Rashid ^{[3
]}

Askenazi, David J. ^{[4
]}

Bagshaw, Sean M. ^{[3
]}

Barhight, Matthew ^{[5
]}

Barreto, Erin ^{[6
]}

Bayrakci, Benan ^{[7
]}

Bignall, Orville N. R. ^{[8
]}

Bjornstad, Erica ^{[4
]}

Brophy, Patrick D. ^{[9
]}

Chanchlani, Rahul ^{[10
]}

Charlton, Jennifer R. ^{[11
]}

Conroy, Andrea L. ^{[12
]}

Deep, Akash ^{[13
]}

Devarajan, Prasad ^{[1
]}

Dolan, Kristin ^{[14
]}

Fuhrman, Dana Y. ^{[15
]}

Gist, Katja M. ^{[1
]}

Gorga, Stephen M. ^{[16
]}

Greenberg, Jason H. ^{[17
]}

Hasson, Denise ^{[1
]}

Ulrich, Emma Heydari ^{[3
]}

Iyengar, Arpana ^{[18
]}

Jetton, Jennifer G. ^{[19
]}

Krawczeski, Catherine ^{[8
]}

Meigs, Leslie ^{[19
]}

Menon, Shina ^{[20
]}

Morgan, Jolyn ^{[1
]}

Morgan, Catherine J. ^{[3
]}

Mottes, Theresa ^{[5
]}

Neumayr, Tara M. ^{[21
]}

Ricci, Zaccaria ^{[22
]}

Selewski, David ^{[23
]}

Soranno, Danielle E. ^{[12
]}

Starr, Michelle ^{[12
]}

Stanski, Natalja L. ^{[1
]}

Sutherland, Scott M. ^{[24
]}

Symons, Jordan ^{[20
]}

Tavares, Marcelo S. ^{[25
]}

Vega, Molly Wong ^{[26
]}

Zappitelli, Michael ^{[27
]}

Ronco, Claudio ^{[28
]}

Mehta, Ravindra L. ^{[29
]}

Kellum, John ^{[30
]}

Ostermann, Marlies ^{[31
]}

Basu, Rajit K. ^{[5
]}

机构：

[1] Cincinnati Childrens Hosp Med Ctr, Ctr Acute Care Nephrol, Cincinnati, OH 45229 USA

[2] Baylor Coll Med, Texas Childrens Hosp, Div Crit Care Med & Nephrol, Houston, TX 77030 USA

[3] Alberta Hlth Sci Univ, Edmonton, AB, Canada

[4] Childrens Hosp Alabama, Birmingham, AL USA

[5] Northwestern Univ, Ann & Robert Lurie Childrens Hosp Chicago, Chicago, IL 60611 USA

[6] Mayo Clin, Rochester, MN USA

[7] Hacettepe Univ, Life Support Ctr, Dept Pediat Intens Care Med, Ankara, Turkey

[8] Ohio State Univ, Nationwide Childrens Hosp, Columbus, OH 43210 USA

[9] Univ Rochester, Med Ctr, Golisano Childrens Hosp, Rochester, NY 14642 USA

[10] McMaster Univ, Hamilton, ON, Canada

[11] Univ Virginia, Charlottesville, VA USA

[12] Indiana Univ, Riley Childrens Hosp, Bloomington, IN USA

[13] Kings Coll London, London, England

[14] Mercy Childrens Hosp Kansas City, Kansas City, MO USA

[15] Univ Pittsburgh, Childrens Hosp Pittsburgh, Med Ctr, Pittsburgh, PA 15213 USA

[16] Univ Michigan, CS Mott Childrens Hosp, Ann Arbor, MI 48109 USA

[17] Yale Univ, Med Ctr, New Haven, CT USA

[18] St Johns Acad Hlth Sci, Bangalore, Karnataka, India

[19] Univ Iowa, Stead Family Childrens Hosp, Iowa City, IA USA

[20] Seattle Childrens Hosp, Seattle, WA USA

[21] Washington Univ, Sch Med, St Louis, MO USA

[22] Univ Florene, Florence, Italy

[23] Med Univ South Carolina, Charleston, SC 29425 USA

[24] Stanford Univ, Lucille Packard Childrens Hosp, Stanford, CA 94305 USA

[25] Santa Casa Belo Horizonte, Belo Horizonte, MG, Brazil

[26] Baylor Coll Med, Texas Childrens Hosp, Div Nephrol, Houston, TX 77030 USA

[27] Hosp Sick Children, Toronto, ON, Canada

[28] Univ Padua, San Bartolo Hosp, Vicenza, Italy

[29] Univ Calif San Diego, San Diego Hlth Sci, San Diego, CA 92103 USA

[30] Univ Pittsburgh, Med Ctr, Pittsburgh, PA USA

[31] Guys & St Thomas Univ, London, England

来源：

JAMA NETWORK OPEN | 2022年 / 5卷 / 09期

关键词：

CRITICALLY-ILL CHILDREN; RENAL REPLACEMENT THERAPY; EXTRACORPOREAL MEMBRANE-OXYGENATION; PEDIATRIC CARDIAC-SURGERY; FLUID OVERLOAD; HOSPITALIZED CHILDREN; OUTCOMES; RISK; MORTALITY; MULTICENTER;

D O I：

10.1001/jamanetworkopen.2022.29442

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

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.

引用

页数：18

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