Report of the first AKI Round Table meeting: an initiative of the ESICM AKI Section

M Ostermann,J Prowle,I Bobek,T Rimmele,L Forni,M Legrand,E Hoste,M Darmon,M Van Dam,M Joannidis,A Zarbock,A Schneider,O Joannes-Boyau

doi:10.1186/s40635-019-0280-z

Abstract

PurposeCritical Care Nephrology is an emerging sub-specialty of Critical Care. Despite increasing awareness about the serious impact of acute kidney injury (AKI) and renal replacement therapy (RRT), important knowledge gaps persist. This report represents a summary of a 1-day meeting of the AKI section of the European Society of Intensive Care Medicine (ESICM) identifying priorities for future AKI research.MethodsInternational Members of the AKI section of the ESICM were selected and allocated to one of three subgroups: “AKI diagnosis and evaluation”, “Medical management of AKI” and “Renal Replacement Therapy for AKI.” Using a modified Delphi methodology, each group identified knowledge gaps and developed potential proposals for future collaborative research.ResultsThe following key research projects were developed: Systematic reviews: (a) epidemiology of AKI with stratification by patient cohorts and diagnostic criteria; (b) role of higher blood pressure targets in patients with hypertension admitted to the Intensive Care Unit, and (c) specific clearance characteristics of different modalities of continuous renal replacement therapy (CRRT).Observational studies: (a) epidemiology of critically ill patients according to AKI duration, and (b) current clinical practice of CRRT.Intervention studies:( a) Comparison of different blood pressure targets in critically ill patients with hypertension, and (b) comparison of clearance of solutes with various molecular weights between different CRRT modalities.ConclusionConsensus was reached on a future research agenda for the AKI section of the ESICM.

Highlights

Acute kidney injury (AKI) is common during critical illness and associated with serious short and long-term complications as well as increased use of health care resources [1,2,3,4,5]
Group 1: Diagnosis and evaluation of AKI The reported incidence of AKI is highly variable [6]. This heterogeneity might be explained by the definitions used (RIFLE, AKIN or Kidney Disease Improving Global Outcomes (KDIGO) criteria), differences in patient populations, case-mix, and clinical setting as well as differences in managing missing data
The current consensus definition of AKI includes the notion of a continuum of disease but there is clear evidence of different sub-categories of AKI, for instance, rapid reversal AKI, persistent AKI and acute kidney disease

Summary

Introduction

Acute kidney injury (AKI) is common during critical illness and associated with serious short and long-term complications as well as increased use of health care resources [1,2,3,4,5]. Despite the increasing number of epidemiological studies highlighting the incidence and outcomes of AKI, this has not translated into any robust strategies to improve patient-. The AKI section of the European Society of Intensive Care Medicine (ESICM) consists of health care professionals from different countries with a mutual interest in adult critical care nephrology. One of their key objectives is to support research and to facilitate clinical and academic collaborations. This approach has already led to successful funding applications, publications in high-impact journals and ongoing research projects, for instance, AKI-Epi [1], PEACE study (ClinicalTrials.gov Identifier: NCT02341885), REVERSE-AKI (ClinicalTrials.gov Identifier: NCT03251131), and PREV-AKI 2 (ClinicalTrials.gov Identifier: NCT03244514)

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