Programs and processes for advancing pediatric acute kidney support therapy in hospitalized and critically ill children: A report from the 26th Acute Disease Quality Initiative (ADQI) consensus conference

Tara M Neumayr, Washington University School of Medicine in St. Louis
Benan Bayrakci, Hacettepe University
Rahul Chanchlani, McMaster University
Akash Deep, King's College London
Jolyn Morgan, Cincinatti Children's Hospital Medical Center
Ayse Akcan Arikan, Baylor College
Rajit K Basu, Northwestern University
Stuart L Goldstein, Cincinatti Children's Hospital Medical Center
David J Askenazi, University Of Alabama At Birmingham
ADQI 26 workgroup

Abstract

Pediatric acute kidney support therapy (paKST) programs aim to reliably provide safe, effective, and timely extracorporeal supportive care for acutely and critically ill pediatric patients with acute kidney injury (AKI), fluid and electrolyte derangements, and/or toxin accumulation with a goal of improving both hospital-based and lifelong outcomes. Little is known about optimal ways to configure paKST teams and programs, pediatric-specific aspects of delivering high-quality paKST, strategies for transitioning from acute continuous modes of paKST to facilitate rehabilitation, or providing effective short- and long-term follow-up. As part of the 26th Acute Disease Quality Initiative Conference, the first to focus on a pediatric population, we summarize here the current state of knowledge in paKST programs and technology, identify key knowledge gaps in the field, and propose a framework for current best practices and future research in paKST.