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A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion
Published on: February 2, 2021
Key performance indicators for acute kidney replacement therapy in critically ill children: a systematic review
Prit Kusirisin1,2, Kristin J Dolan3, Rashid Alobaidi4
1Department of Critical Care Medicine, Faculty of Medicine and Dentistry, Critical Care Medicine, University of Alberta, and Alberta Health Services, 2-124E Clinical Sciences Building, 8440 112 St NW, Edmonton, AB, T6G 2B7, Canada.
Pediatric Nephrology (Berlin, Germany)
|May 7, 2026
Summary
This review identified multiple key performance indicators (KPIs) for pediatric kidney replacement therapy (KRT) but found inconsistent definitions and validation. Standardizing these KPIs is crucial for improving KRT quality in critically ill children.
Area of Science:
- Pediatric Nephrology
- Critical Care Medicine
- Quality Improvement Science
Background:
- Acute kidney injury (AKI) is prevalent in critically ill children, significantly increasing morbidity and mortality, especially with kidney replacement therapy (KRT).
- Standardizing KRT delivery is essential for accurate outcome assessment and quality improvement initiatives.
- Key performance indicators (KPIs) are vital for monitoring KRT processes and guiding decision-making.
Purpose of the Study:
- To systematically review existing evidence on KPIs related to KRT delivery in critically ill pediatric populations.
- To identify and evaluate the current landscape of KPIs used in pediatric KRT.
Main Methods:
- A comprehensive literature search was conducted across major databases (Ovid MEDLINE, Embase, CINAHL, Cochrane Library) up to February 2025.
- Studies reporting KPIs for dialysis processes in critically ill children receiving KRT were included.
- Six reviewers screened, selected, and appraised studies; data were synthesized narratively using the Donabedian framework.
Main Results:
- 107 studies met inclusion criteria, with most (66.7%) being of moderate quality.
- Six key KPIs were identified: solute clearance, filter life, downtime, fluid management, hypotension, and prescription.
- KPI definitions were heterogeneous, and their categorization showed variability in importance, scientific acceptability, and feasibility.
Conclusions:
- The systematic review highlights a need for standardized and validated KPIs in pediatric KRT due to inconsistent definitions and study quality.
- There is a clear need to establish a concise, prioritized set of KPIs to effectively measure, benchmark, and enhance KRT quality for critically ill children.
- Further research focusing on structured quality improvement initiatives is recommended to advance the field.
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