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

Pediatric ADQI Collaborative

    Research output: Contribution to journalArticlepeer-review

    70 Citations (Scopus)

    Abstract

    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. To develop expert-driven pediatric specific recommendations on needed AKI research, education, practice, and advocacy. 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. 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. 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.
    Original languageEnglish
    Pages (from-to)e2229442
    JournalJAMA Network open
    Volume5
    Issue number9
    DOIs
    Publication statusE-pub ahead of print - 1 Sept 2022

    Keywords

    • Consensus
    • Child
    • Acute Kidney Injury - diagnosis - epidemiology - therapy
    • Critical Care
    • Nephrology
    • Delphi Technique
    • Humans

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