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Consensus-Based Recommendations on Priority Activities to Address Acute Kidney Injury in Children: A Modified Delphi
Stuart L Goldstein1, Ayse Akcan-Arikan2, Rashid Alobaidi3
1Center for Acute Care Nephrology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
JAMA Network Open
|September 30, 2022
Summary
Acute kidney injury (AKI) affects many children and young adults, necessitating focused research and improved care. This study provides expert recommendations to advance pediatric AKI knowledge and outcomes.
Area of Science:
- Pediatric Nephrology
- Critical Care Medicine
- Public Health
Background:
- Acute kidney injury (AKI) is increasingly recognized in pediatric and young adult populations.
- AKI in children is linked to adverse short-term and long-term health consequences.
- There is a critical need for enhanced knowledge and focused efforts in pediatric AKI.
Purpose of the Study:
- To establish expert-driven, pediatric-specific recommendations for AKI research.
- To guide improvements in pediatric AKI education, clinical practice, and advocacy.
- To address knowledge gaps and improve outcomes for children with AKI.
Main Methods:
- Convened 47 international experts in pediatrics, nephrology, and critical care for the 26th Acute Disease Quality Initiative meeting.
- Conducted a comprehensive review of literature up to September 2021 across six key AKI domains.
- Utilized a modified Delphi process to derive consensus statements and research recommendations.
Main Results:
- Generated 12 consensus statements and 29 research recommendations for pediatric AKI.
- Highlighted the need for research including diverse socioeconomic groups and broader AKI phenotype definitions.
- Recommended improved fluid balance assessment, integration of growth/developmental biopathology, and family/community partnerships in advocacy.
Conclusions:
- Observational evidence underscores the importance of further research in childhood AKI.
- Focused research efforts are essential to address significant knowledge gaps in pediatric AKI.
- These recommendations provide a roadmap for advancing pediatric AKI care and research.
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