1,721,044 research outputs found
Nomenclature for continuous renal replacement therapies
No full textContinuous renal replacement therapies (CRRTs) have evolved over the last decade, but there is no standard terminology for the defferent methods in use, At an International Conference on CRRT, held in San Diego, CA, November 9-10, 1995, an international panel of experts developed a proposed nomenclature for these therapies, The nomenclature was developed to define common terms and to use a standardized language when papers in the field of CRRT are reviewed and published, This article describes the definition for each technique, It is hoped that these definitions will be used as a framework for subsequent descriptions of new techniques in the literature. (C) 1996 by the National Kidney Foundation, Inc
Proceedings of the International Conference on Continuous Renal Replacement Therapy - November 9-10, 1995 - Introduction
No full textAcute dialysis quality initiative (ADQI)
No full textA new star is born. Its name is ADQI which stands for Acute Dialysis Quality Initiative. In the firmament of guidelines and directions for appropriate management of renal diseases, little has been done so far concerning acute renal failure and its treatment. For this reason we felt that a process seeking consensus and evidence-based statements in the field of acute renal failure was needed
Timing of initiation and discontinuation of renal replacement therapy in AKI: Unanswered key questions
No full textPatients with acute kidney injury (AKI) often require initiation of renal replacement therapy (RRT). Currently, there is wide variation worldwide on the indications for and timing of initiation and discontinuation of RRT for AKI. Various parameters for metabolic, solute, and fluid control are generally used to guide the initiation and discontinuation of therapy; however, there are currently no standards in this field. Members of the recently established Acute Kidney Injury Network, representing key societies in critical care and nephrology along with additional experts in adult and pediatric AKI, participated in a 3-d conference in Vancouver in September 2006 to evaluate the available literature on this topic and draft consensus recommendations for research studies in this area. Key questions included the following: what are the indications for RRT, when should acute RRT support be initiated, and when should RRT be stopped? This report summarizes the available evidence and describes in detail the key questions, and some of the methods of answering them that will need to be addressed with the goal of standardizing the care of patients with AKI and improving outcomes
Development of a clinical research agenda for acute kidney injury using an international, interdisciplinary, three-step modified Delphi process
No full textBackground and objectives: Although acute kidney injury is common and significantly increases the risk for intensive care unit and hospital mortality, little is known about its true incidence or how it can be prevented. Furthermore, key unanswered questions remain about the optimal diagnosis and treatment of patients with acute kidney injury. An international, consensus-based, prioritized research agenda was sought to guide clinical and translational research in acute kidney injury. Design, setting, participants, & measurements: A three-step modified Delphi process involving 43 participants representing 19 professional societies, organizations, and multiple stakeholder groups ranging from clinical practice to basic science research was conducted. Results: Twenty research questions were generated across six focus groups. Overall, research priorities generated from nephrologists and intensivists were similar and highly correlated. The stakeholder groups included members from 15 countries. Results from adult and pediatric groups showed important differences, as did results from developing compared with developed countries; however the priority rankings from the developed and developing countries were significantly correlated. Top research priorities in acute kidney injury include determining optimal timing of renal replacement therapy and improving the understanding of the epidemiology of acute kidney injury around the world. Conclusions: Research recommendations that are highly consistent across various stakeholder groups and between developed and developing countries have been produced. It is hoped that these recommendations will prove valuable in guiding future clinical and translational research in this area
The epidemiology of cardiac surgery-associated acute kidney injury
No full textPurpose: To describe current knowledge on the epidemiology of cardiac surgery-associated acute kidney injury (CSA-AKI) and to formulate recommendations for clinical practice and a research agenda. Methods: After a modified Delphi analysis by the Acute Dialysis Quality Initiative (ADQI), 4 questions on the epidemiology of CSA-AKI and recommendations for clinical practice and a research agenda were formulated and addressed. Results: Existing studies on CSA-AKI use over 35 different definitions for CSA-AKI. In addition, there may be important differences in patient characteristics and procedures. This explains the significant variations in reported incidence. Most studies report on CSA-AKI as defined by the need for renal replacement therapy. However, even small decreases in kidney function are associated with a worsened outcome. The workgroup formulated the recommendation to use the AKIN consensus criteria for AKI. One should differentiate early CSA-AKI, caused by the procedure, and late CSA-AKI, associated with the procedure. There may be different clinical scenarios: acute on chronic CSA-AKI, AKI prior to CS, and AKI occurring post CS. Risk factors should be differentiated between pre-, intra-, and post-CS, and between patient-, process-, and procedure-related. Endpoints should include both short-term and long-term outcomes. Conclusions: Existing data on the epidemiology of CSA-AKI are difficult to compare due to variations in definition and patient cohort. A modified Delphi analysis resulted in a series of recommendations for future research on CSA-AKI
Acute kidney injury: time to shift from creatinine to the estimated glomerular filtration rate? Response
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