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Technical Refinement of a Bilateral Renal Ischemia-Reperfusion Mouse Model for Acute Kidney Injury Research
Published on: November 3, 2023
Development of a clinical research agenda for acute kidney injury using an international, interdisciplinary,
John A Kellum1, Ravindra L Mehta, Adeera Levin
1Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Scaife Hall, Room 608, 3550 Terrace Street, Pittsburgh, PA 15261, USA. kellumja@ccm.upmc.edu
Background 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.
Insights
This study outlines a global research agenda for acute kidney injury (AKI), identifying key priorities for diagnosis, prevention, and treatment to reduce mortality. The research aims to guide future clinical and translational studies in AKI.
Area of Science:
- Nephrology
- Critical Care Medicine
- Epidemiology
Background:
- Acute kidney injury (AKI) is prevalent and linked to increased mortality.
- Significant gaps exist in understanding AKI incidence, prevention, diagnosis, and treatment.
- An international research agenda is needed to address these knowledge gaps.
Purpose of the Study:
- To establish a consensus-based, prioritized research agenda for acute kidney injury.
- To guide future clinical and translational research in AKI.
Main Methods:
- A three-step modified Delphi process was employed.
- 43 participants from 19 professional societies and stakeholder groups were involved.
- The process spanned international and multidisciplinary perspectives.
Main Results:
- Twenty research questions were identified across six focus groups.
- Priorities from nephrologists and intensivists showed strong correlation.
- Key priorities include optimal renal replacement therapy timing and global AKI epidemiology.
Conclusions:
- A consistent research agenda was developed across diverse stakeholder groups and countries.
- These recommendations aim to advance AKI research and patient care.
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