Pragmatic studies for acute kidney injury: Consensus report of the Acute Disease Quality Initiative (ADQI) 19 Workgroup

Zhiyong Peng; Kaijiang Yu; Marlies Ostermann; XiuMing Xi; Raymond Hsu; Jean-Louis Vincent; John R Prowle; Bin Du; Martin Gallagher; Changsong Wang; Raghavan Murugan; Haibo Qiu; Thomas Rimmelé; Jianguo Li; Lui G Forni; Kianoush Kashani; Claudio Ronco; John A Kellum; Acute Disease Quality Initiative (ADQI) Workgroup 19

doi:10.1016/j.jcrc.2017.12.006

Pragmatic studies for acute kidney injury: Consensus report of the Acute Disease Quality Initiative (ADQI) 19 Workgroup

J Crit Care. 2018 Apr:44:337-344. doi: 10.1016/j.jcrc.2017.12.006. Epub 2017 Dec 12.

Authors

Zhiyong Peng¹, Kaijiang Yu², Marlies Ostermann³, XiuMing Xi⁴, Raymond Hsu⁵, Jean-Louis Vincent⁶, John R Prowle⁷, Bin Du⁸, Martin Gallagher⁹, Changsong Wang¹⁰, Raghavan Murugan¹¹, Haibo Qiu¹², Thomas Rimmelé¹³, Jianguo Li¹⁴, Lui G Forni¹⁵, Kianoush Kashani¹⁶, Claudio Ronco¹⁷, John A Kellum¹⁸; Acute Disease Quality Initiative (ADQI) Workgroup 19

Affiliations

¹ Critical Care Medicine, Wuhan University Zhongnan Hospital, Wuhan 430071, Hubei, China. Electronic address: [email protected].
² Chinese Society of Critical Care Medicine, Harbin Medical University The Third Affiliated Hospital, Harbin, China. Electronic address: [email protected].
³ Guy's & St. Thomas' Hospital, London, UK. Electronic address: [email protected].
⁴ Chinese Association of Critical Care Physicians, Fuxin Hospital, Capital Medical University, Beijing, China.
⁵ Division of Nephrology, University of California San Francisco, San Francisco, CA, USA. Electronic address: [email protected].
⁶ Intensive Care Medicine, Dept. of Intensive Care, Erasme Univ Hospital, Route de Lennik, 808, 1070 Brussels, Belgium. Electronic address: [email protected].
⁷ William Harvey Research Institute, Queen Mary University of London, Adult Critical Care Unit, Royal London Hospital, Whitechapel Road, London E1 1BB, UK. Electronic address: [email protected].
⁸ Chinese Association of Critical Care Physicians, Peiking Union Hospital, Beijing, China.
⁹ George Institute for Global Health, Concord Clinical School, Sydney Medical School, PO Box M201, Missenden Rd, NSW 2050, Australia. Electronic address: [email protected].
¹⁰ Department of Critical Care, Harbin Medical University The Third Affiliated Hospital, Harbin, China.
¹¹ Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, USA. Electronic address: [email protected].
¹² Chinese Society of Critical Care Medicine, Zhongda Hospital, Nanjing, China.
¹³ Anesthesiology and Intensive Care Medicine, Edouard Herriot Hospital, 5 place d'Arsonval, 69003 Lyon, France.
¹⁴ Chinese Society of Critical Care Medicine, Wuhan University Zhongnan Hospital, Wuhan, China.
¹⁵ Intensive Care Unit, Royal Surrey County Hospital NHS Foundation Trust, Egerton Road, Guildford, UK; Department of Clinical & Experimental Medicine, Faculty of Health Sciences, University of Surrey, Guildford, UK. Electronic address: [email protected].
¹⁶ Division of Pulmonary and Critical Care, Mayo Clinic, College of Medicine, 200 First Street Southwest, Rochester, MN 55905, USA. Electronic address: [email protected].
¹⁷ International Renal Research Institute of Vicenza, San Bortolo Hospital, Vicenza, Italy.
¹⁸ Department of Critical Care Medicine, Center for Critical Care Nephrology, University of Pittsburgh School of Medicine, Pittsburgh, USA. Electronic address: [email protected].

PMID: 29274596
DOI: 10.1016/j.jcrc.2017.12.006

Abstract

Purpose: Acute kidney injury (AKI) has become a major medical and financial burden in China along with the rest of the world. There have been considerable advances in the understanding of the epidemiology and pathogenesis of AKI. However, there is no consensus regarding the optimal care for patients. The Acute Disease Quality Initiative (ADQI) 19 meeting focused on identifying and designing relevant and achievable AKI-related studies in China.

Materials & methods: The working group developed a list of preliminary questions and objectives and performed analysis of the existing literature. Relevant studies were identified through a literature search using the MEDLINE database and bibliographies of relevant research and review articles. We then used a two-step Delphi process to prioritize a research agenda and proposed specific study designs to address unmet needs.

Results: Important gaps in existing knowledge were identified and pragmatic studies were proposed in three distinct areas: care bundles for AKI prevention, renal replacement therapy (RRT) for AKI, and fluid management. In addition, the use of biomarkers to guide clinical trials was discussed.

Conclusions: Consensus was reached on a research agenda for AKI with a specific focus on pragmatic trials in China.

Keywords: Acute kidney injury; Pragmatic trials; Renal replacement therapy; Resuscitation; Sepsis.

Publication types

Research Support, Non-U.S. Gov't
Systematic Review

MeSH terms

Acute Disease
Acute Kidney Injury*
Consensus*
Humans
Pragmatic Clinical Trials as Topic
Quality Indicators, Health Care
Renal Replacement Therapy