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1. Assessing the role of Chemokine (C–C motif) ligand 14 in AKI: a European consensus meeting

Author

Jay L. Koyner, Christian Arndt, Jaume Baldira Martinez de Irujo, Sílvia Coelho, Manuel Garcia-Montesinos de la Peña, Luca di Girolamo, Michael Joannidis, Pablo Jorge-Monjas, Christian Koch, Steven Lobaz, Alain Meyer, Marlies Ostermann, Nicoletta Pertica, John R. Prowle, Jon Silversides, Alexander Zarbock, Jorge Echeverri, Kai Harenski, and Lui G. Forni

Subjects
Biomarker testing experience, C‑C motif chemokine ligand 14 (CCL14), consensus, critical care nephrology, persistent acute kidney injury, Diseases of the genitourinary system. Urology, RC870-923
Abstract

Background Urinary Chemokine (C–C motif) ligand 14 (CCL14) is a biomarker associated with persistent severe acute kidney injury (AKI). There is limited data to support the implementation of this AKI biomarker to guide therapeutic actions.Methods Sixteen AKI experts with clinical CCL14 experience participated in a Delphi-based method to reach consensus on when and how to potentially use CCL14. Consensus was defined as ≥ 80% agreement (participants answered with ‘Yes’, or three to four points on a five-point Likert Scale).Results Key consensus areas for CCL14 test implementation were: identifying challenges and mitigations, developing a comprehensive protocol and pairing it with a treatment plan, and defining the target population. The majority agreed that CCL14 results can help to prioritize AKI management decisions. CCL14 levels above the high cutoff (> 13 ng/mL) significantly changed the level of concern for modifying the AKI treatment plan (p 13 ng/mL. The level of concern for discussion on RRT initiation between High and Low, and between Medium and Low CCL14 levels, showed significant differences.Conclusion Real world urinary CCL14 use appears to provide improved care options to patients at risk for persistent severe AKI. Experts believe there is a role for CCL14 in AKI management and it may potentially reduce AKI-disease burden. There is, however, an urgent need for evidence on treatment decisions and adjustments based on CCL14 results.

Published
2024
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2. Serial Urinary C-C Motif Chemokine Ligand 14 and Risk of Persistent Severe Acute Kidney Injury

Author

John R. Prowle, MD, Antonio Artigas, MD, Sean M. Bagshaw, MD, Lui G. Forni, PhD, Michael Heung, MD, Eric Hoste, PhD, Ostermann Marlies, PhD, Jay L. Koyner, MD, Lakmir Chawla, MD, J. Patrick Kampf, PhD, Thomas Kwan, PhD, Paul McPherson, PhD, John A. Kellum, MD, for the Sapphire and Ruby Investigators, K Kashani, A Al-Khafaji, T Ardiles, A Artigas, SM Bagshaw, M Bell, A Bihorac, R Birkhahn, CM Cely, LS Chawla, D Davison, T Feldkamp, LG Forni, MN Gong, KJ Gunnerson, M Haase, J Hackett, P Honore, EAJ Hoste, O Joannes-Boyau, M Joannidis, P Kim, JL Koyner, DT Laskowitz, ME Lissauer, G Marx, PA McCullough, S Mullaney, M Ostermann, T Rimmele, NI Shapiro, AD Shaw, J Shi, MG Walker, AM Sprague, JL Vincent, C Vinsonneau, L Wagner, RG Wilkerson, K Zacharowski, JA Kellum, Eric Hoste, Azra Bihora, Ali Al-Khafaji, Luis M. Ortega, Marlies Ostermann, Michael Haase, Kai Zacharowski, Richard Wunderink, Michael Heung, Kyle Gunnerson, Matthew Lissauer, Daniel Herr, Wesley H. Self, Jay L. Koyner, Patrick M. Honore, John R. Prowle, Danielle Davison, Antonio Artigas, Michael Joannidis, Rebecca Schroeder, Sevag Demirjian, Lui G. Forni, Luke Hodgson, Scott T. Wilber, Jennifer A. Frey, Ian Reilly, Jing Shi, J. Patrick Kampf, Thomas Kwan, Paul McPherson, John A. Kellum, and Lakhmir S. Chawla

Subjects
Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

OBJECTIVES:. To assess the added prognostic value of serial monitoring of urinary C-C motif chemokine ligand 14 (uCCL14) over that of single measurements, which have been shown to be prognostic for development of persistent severe acute kidney injury (AKI) in critically ill patients. DESIGN:. Retrospective observational study. SETTING:. Data derived from two multinational ICU studies (Ruby and Sapphire). PATIENTS:. Critically ill patients with early stage 2–3 AKI. INTERVENTIONS:. None. MEASUREMENTS AND MAIN RESULTS:. We analyzed three consecutive uCCL14 measurements at 12-hour intervals after diagnosis of stage 2–3 AKI by Kidney Disease Improving Global Outcomes criteria. Primary outcome was persistent severe AKI, defined as 72 consecutive hours of stage 3 AKI, death, or receipt of dialysis prior to 72 hours. uCCL14 was measured using the NEPHROCLEAR uCCL14 Test on the Astute 140 Meter (Astute Medical, San Diego, CA). Based on predefined, validated cutoffs, we categorized uCCL14 as: low (≤ 1.3 ng/mL), medium (> 1.3 to ≤ 13 ng/mL), or high (> 13 ng/mL). Seventy-five of 417 patients with three consecutive uCCL14 measurements developed persistent severe AKI. Initial uCCL14 category strongly correlated with primary endpoint and, in most cases (66%), uCCL14 category was unchanged over the first 24 hours. Compared with no change and accounting for baseline category, decrease in category was associated with decreased odds of persistent severe AKI (odds ratio [OR], 0.20; 95% CI, 0.08–0.45; p < 0.001) and an increase in category with increased odds (OR, 4.04; 95% CI, 1.75–9.46; p = 0.001). CONCLUSIONS:. In one-third of patients with moderate to severe AKI uCCL14 risk category altered over three serial measurements and such changes were associated with altered risk for persistent severe AKI. Serial CCL-14 measurement may detect progression or resolution of underlying kidney pathology and help refine AKI prognosis.

Published
2023
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3. Biomarker-guided intervention to prevent acute kidney injury after major surgery (BigpAK-2 trial): study protocol for an international, prospective, randomised controlled multicentre trial

Author

Joachim Gerss, Javier Ripollés-Melchor, Emmanuel Futier, Melanie Meersch, Carola Wempe, Detlef Kindgen-Milles, Alexander Zarbock, Markus W Hollmann, Sigismond Lasocki, Thomas Rimmele, Tim Rahmel, Michael Adamzik, Hartmuth Nowak, Ingeborg Welters, Brian Johnston, Ane Abad-motos, Alfredo Abad-gurumeta, Marc Moritz Berger, Davide Ricci, Maurizio Cecconi, Gudrun Kunst, Christian Stoppe, Christian Putensen, Marlies Ostermann, Sascha Ott, Brijesh Patel, Gabriele Baldini, Antoine Lamblin, Karen Williams, Elena Mancini, Christian Arndt, Hinnerk Wulf, Marc Irqsusi, Wim Vandenberghe, John Kellum, Raphael Weiss, Jackie Donovan, Lui G Forni, Giacomo Monti, Céline Monard, Markus A Weigand, Thorsten Brenner, Ulrich Jaschinski, Carlos Lopez, Maxime Leger, Emmanuel Rineau, Philipp Simon, María Gómez-Rojo, Lars Bergmann, Alicia Waite, Savino Spadaro, Alexander Wolf, Andrew Spence, Simon Dubler, Alexander PJ Vlaar, Patrick Schober, Ben C Creagh-Brown, Nandor Marczin, Emilio Maseda, Christian Strauss, Stefano Romagnoli, Christian Nusshag, Ulrich Gobel, Ángel Candela-Toha, Jon Silversides, Nuttha Lumlertgul, Khaschayar Saadat-Gilani, Vincent Legros, Timo Brandenburger, Thomas Dimski, Laura Huthmann, Claude Pelletier, Manon Schleß, Peter Rosenberger, Helene Häberle, Jan Gerrit Haaker, Matthias Gründel, Lucia Cattin, Laura Villarino Villa, Juan Victor Lorente, Christine Martin, Jan Larmann, Wolfgang Bauer, Giovanni Borghi, Benjamin O’Brien, Thilo von Groote, Antoine Guillaume Schneider, Silvia De Rosa, Diego Parise, Alice Bernard, Paula Fernández-Valdes-Bango, Irene Romero Bhathal, A Suarez-de-la-Rica, Gianluca Villa, Raquel García-Álvarez, Antonio Siniscalchi, Richard Ellerkmann, Florian Espeter, Christian Porschen, Mahan Sadjadi, Michael Storck, Tobias Brix, Dana Meschede, Wida Amini, Carina Stenger, Julius Freytag, Jens Brands, Matthias Unterberg, Britta Marko, Fabian Dusse, Wolfgang A Wetsch, Sandra E Stoll, Hendrik Drinhaus, Bernd W Böttiger, Onnen Mörer, Lars-Olav Harnisch, Roswitha Lubjuhn, Daniel Heise, Christian Bode, Andrea Sauer, Konrad Peukert, Lennart Wild, Philippe Kruse, Jan Menzenbach, Valbona Mirakaj, Sabine Hermann, Stefanie Decker, Mona Jung-König, Tobias Hölle, Sarah Dehne, Jörg Reutershan, Thomas Prüfer, Stefan Pielmeier, Indra Wimmelmeier, Michaela Scholz, Andrea Paris, Isabel Christina Gallego Zapata, Holger Pohl, Nirmeen Fayed, Kai Dielmann, Evelyn Martin, Tilo Koch, Alexander Mück, Philipp Deetjen, Ngoc Bich Mehlmann, Peter M Spieth, Andreas Güldner, Axel Rand, Maximillian Ragaller, Martin Mirus, Rebecca Bockholt, Marc Herzog, Maren Kleine-Brüggeney, Ant Isabelle Cristiani, Marion Ohl, Monica Vieira Da Silva, Gilda Filipe de Castro Reblo, Matthias Hilty, Katharina Spanaus, Benedetta Mura, Eleonora Terreni, Francesco Magiotti, Lorenzo Turi, Cristiana Laici, Chiara Capozzi, Andrea Castelli, Massimiliano Greco, Antonio Messina, Gianluca Castellani, Romina Aceto, Vinicio Danzi, Alessandro Rigobello, Massimo De Cal, Monica Zanella, Gaetano Scaramuzzo, Riccardo La Rosa, Paolo Priani, Alberto Volta Carlo, Stefano Turi, Martina Baiardo Redaelli, Marilena Marmiere, Kittisak Weerapolchai, Shelley Lorah, Fabiola D’Amato, Aneta Bociek, Rosario Lim, Benjie Cendreda, Reynaldo Dela Cuesta, Eirini Kosifidou, Zoka Milan, Juliana Fernanda, Emma Clarey, Daveena Meeks, Nicholas J Lees, Marco Scaramuzzi, Orinta Kviatkovske, Adam Glass, Christine Turley, Charlotte Quinn, Syeda Haider, Adam Rossiter, Syed Nasser, Ned Gilbert-Kawai, Tatjana Besse-Hammer, Eric Hoste, Hannah Schaubroeck, Jan De Waele, Jenni Breel, Eline de Klerk, Harm-Jan de Grooth, Lothar Schwarte, Alexander Loer, Alicia Ruiz-Escobar, Diana Fernández-García, Nerea Gómez-Pérez, Pascual Crespo-Aliseda, Cristina Cerro-Zaballos, Cristina Fernández-Martín, Eduardo Martín-Montero, Alejandro Suarez de la Rica, Héctor Berges Gutiérrez, Maria del Pino Heredia Pérez, Maria de los Reyes Bellido Fernández, Liena Izquierdo López, Javier Valiente Lourtau, Ma Angeles Ferre Colomer, Ma Azucena Pajares Moncho, Maria Jesús Montero Hernández, Esther Pérez Sancho, Silvia Polo Matínez, Pedro Rivera Soria, Maider Puyada Jáuregui, Hugo Rivera Ramos, Marta Antelo Adrán, Ramón Adalia Bartolomé, Patricia Galán Menéndez, Laura Llinares Espin, Yuri Santiago Loaiza Aldean, Víctor MoralesAriza, Rosalía Navarro-Perez, Luis Santé-Serna, Pedro de la Calle-Elguezabal, Rubén Sánchez-Martín, Inés De Soto, Pau Vallhonrat Alcántara, Laura Perelló Cerdà, Gal·la Rouras Hurtado, Paula Rodriguez Nieto, John Narros Sicluna, Angel Molero Molinero, Juan Pablo Nocete, Elena Murcia Sánchez, Stanislas Abrard, Marie-Luce Parrouffe, Frank Bidar, Lucie Aupetitgendre, Ugo Schiff, Bertille Paquette, Gaëlle Sellier, Nathalie Borgnetta, Benjamin Brochet, Thierry Floch, Julien Coffinet, and Marion Leclercq-Rouget

Subjects
Medicine
Abstract

Introduction Previous studies demonstrated that the implementation of the Kidney Disease Improving Global Outcomes (KDIGO) guideline-based bundle, consisting of different supportive measures in patients at high risk for acute kidney injury (AKI), might reduce rate and severity of AKI after surgery. However, the effects of the care bundle in broader population of patients undergoing surgery require confirmation.Methods and analysis The BigpAK-2 trial is an international, randomised, controlled, multicentre trial. The trial aims to enrol 1302 patients undergoing major surgery who are subsequently admitted to the intensive care or high dependency unit and are at high-risk for postoperative AKI as identified by urinary biomarkers (tissue inhibitor of metalloproteinases 2*insulin like growth factor binding protein 7 (TIMP-2)*IGFBP7)). Eligible patients will be randomised to receive either standard of care (control) or a KDIGO-based AKI care bundle (intervention). The primary endpoint is the incidence of moderate or severe AKI (stage 2 or 3) within 72 hours after surgery, according to the KDIGO 2012 criteria. Secondary endpoints include adherence to the KDIGO care bundle, occurrence and severity of any stage of AKI, change in biomarker values during 12 hours after initial measurement of (TIMP-2)*(IGFBP7), number of free days of mechanical ventilation and vasopressors, need for renal replacement therapy (RRT), duration of RRT, renal recovery, 30-day and 60-day mortality, intensive care unit length-of-stay and hospital length-of-stay and major adverse kidney events. An add-on study will investigate blood and urine samples from recruited patients for immunological functions and kidney damage.Ethics and dissemination The BigpAK-2 trial was approved by the Ethics Committee of the Medical Faculty of the University of Münster and subsequently by the corresponding Ethics Committee of the participating sites. A study amendment was approved subsequently. In the UK, the trial was adopted as an NIHR portfolio study. Results will be disseminated widely and published in peer-reviewed journals, presented at conferences and will guide patient care and further research.Trial registration number NCT04647396.

Published
2023
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4. Quality of Care for Acute Kidney Disease: Current Knowledge Gaps and Future Directions

Author

Kathleen D. Liu, Lui G. Forni, Michael Heung, Vin-Cent Wu, John A. Kellum, Ravindra L. Mehta, Claudio Ronco, Kianoush Kashani, Mitchell H. Rosner, Michael Haase, Jay L. Koyner, and Ravi Mehta

Subjects
acute kidney injury, outcomes, quality, recovery, Diseases of the genitourinary system. Urology, RC870-923
Abstract

Acute kidney injury (AKI) and acute kidney disease (AKD) are common complications in hospitalized patients and are associated with adverse outcomes. Although consensus guidelines have improved the care of patients with AKI and AKD, guidance regarding quality metrics in the care of patients after an episode of AKI or AKD is limited. For example, few patients receive follow-up laboratory testing of kidney function or post-AKI or AKD care through nephrology or other providers. Recently, the Acute Disease Quality Initiative developed a consensus statement regarding quality improvement goals for patients with AKI or AKD specifically highlighting efforts regarding quality and safety of care after hospital discharge after an episode of AKI or AKD. The goal is to use these measures to identify opportunities for improvement that will positively affect outcomes. We recommend that health care systems quantitate the proportion of patients who need and actually receive follow-up care after the index AKI or AKD hospitalization. The intensity and appropriateness of follow-up care should depend on patient characteristics, severity, duration, and course of AKI of AKD, and should evolve as evidence-based guidelines emerge. Quality indicators for discharged patients with dialysis requiring AKI or AKD should be distinct from end-stage renal disease measures. Besides, there should be specific quality indicators for those still requiring dialysis in the outpatient setting after AKI or AKD. Given the limited preexisting data guiding the care of patients after an episode of AKI or AKD, there is ample opportunity to establish quality measures and potentially improve patient care and outcomes. This review will provide specific evidence-based and expert opinion–based guidance for the care of patients with AKI or AKD after hospital discharge.

Published
2020
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5. Cytokine removal in human septic shock: Where are we and where are we going?

Author

Patrick M. Honore, Eric Hoste, Zsolt Molnár, Rita Jacobs, Olivier Joannes-Boyau, Manu L. N. G. Malbrain, and Lui G. Forni

Subjects
Blood purification, Cytokines, Sepsis, Septic shock, Haemoperfusion, Cytosorb, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Abstract Although improving, the mortality from septic shock still remains high despite increased international awareness. As a consequence, much effort has focused on alternative treatment strategies in an effort to improve outcomes. The application of blood purification therapies to improve immune homeostasis has been suggested as one such method, but these approaches, such as high-volume continuous haemofiltration or cytokine and/or endotoxin removal, have enjoyed little success to date. More recently, the use of sorbent technologies has attracted much attention. These adsorbers are highly effective at removing inflammatory mediators, in particular, cytokines, from the bloodstream. This narrative review is the executive summary of meetings held throughout the 6th International Fluid Academy Days in Antwerp, Belgium (Nov 23–25, 2017), focusing on the current understanding regarding the use of such adsorbers in humans with septic shock. We followed a modified Delphi approach involving a combination of evidence appraisal together with expert opinion in order to achieve recommendations for practice and, importantly, future research.

Published
2019
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6. Clinical decision-making in older adults following emergency admission to hospital. Derivation and validation of a risk stratification score: OPERA.

Author

Khushal Arjan, Lui G Forni, Richard M Venn, David Hunt, and Luke Eliot Hodgson

Subjects
Medicine, Science
Abstract

Objectives of the studyDemographic changes alongside medical advances have resulted in older adults accounting for an increasing proportion of emergency hospital admissions. Current measures of illness severity, limited to physiological parameters, have shortcomings in this cohort, partly due to patient complexity. This study aimed to derive and validate a risk score for acutely unwell older adults which may enhance risk stratification and support clinical decision-making.MethodsData was collected from emergency admissions in patients ≥65 years from two UK general hospitals (April 2017- April 2018). Variables underwent regression analysis for in-hospital mortality and independent predictors were used to create a risk score. Performance was assessed on external validation. Secondary outcomes included seven-day mortality and extended hospital stay.ResultsDerivation (n = 8,974) and validation (n = 8,391) cohorts were analysed. The model included the National Early Warning Score 2 (NEWS2), clinical frailty scale (CFS), acute kidney injury, age, sex, and Malnutrition Universal Screening Tool. For mortality, area under the curve for the model was 0.79 (95% CI 0.78-0.80), superior to NEWS2 0.65 (0.62-0.67) and CFS 0.76 (0.74-0.77) (P30 days.ConclusionsOur simple validated model (Older Persons' Emergency Risk Assessment [OPERA] score) predicts in-hospital mortality and prolonged length of stay and could be easily integrated into electronic hospital systems, enabling automatic digital generation of risk stratification within hours of admission. Future studies may validate the OPERA score in external populations and consider an impact analysis.

Published
2021
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7. Recommendations for clinical trial design in acute kidney injury from the 31st acute disease quality initiative consensus conference. A consensus statement

Author

Zarbock, Alexander, Forni, Lui G., Koyner, Jay L., Bell, Samira, Reis, Thiago, Meersch, Melanie, Bagshaw, Sean M., Fuhmann, Dana Y., Liu, Kathleen D., Pannu, Neesh, Arikan, Ayse Akcan, Angus, Derek C., Duquette, D‘Arcy, Goldstein, Stuart L., Hoste, Eric, Joannidis, Michael, Jongs, Niels, Legrand, Matthieu, Mehta, Ravindra L., Murray, Patrick T., Nadim, Mitra K., Ostermann, Marlies, Prowle, John, See, Emily J., Selby, Nicholas M., Shaw, Andrew D., Srisawat, Nattachai, Ronco, Claudio, and Kellum, John A.

Published
2024
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8. Definitions and pathophysiology of vasoplegic shock

Author

Simon Lambden, Ben C. Creagh-Brown, Julie Hunt, Charlotte Summers, and Lui G. Forni

Subjects
Vasoplegia, Shock, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Abstract Vasoplegia is the syndrome of pathological low systemic vascular resistance, the dominant clinical feature of which is reduced blood pressure in the presence of a normal or raised cardiac output. The vasoplegic syndrome is encountered in many clinical scenarios, including septic shock, post-cardiac bypass and after surgery, burns and trauma, but despite this, uniform clinical definitions are lacking, which renders translational research in this area challenging. We discuss the role of vasoplegia in these contexts and the criteria that are used to describe it are discussed. Intrinsic processes which may drive vasoplegia, such as nitric oxide, prostanoids, endothelin-1, hydrogen sulphide and reactive oxygen species production, are reviewed and potential for therapeutic intervention explored. Extrinsic drivers, including those mediated by glucocorticoid, catecholamine and vasopressin responsiveness of the blood vessels, are also discussed. The optimum balance between maintaining adequate systemic vascular resistance against the potentially deleterious effects of treatment with catecholamines is as yet unclear, but development of novel vasoactive agents may facilitate greater understanding of the role of the differing pathways in the development of vasoplegia. In turn, this may provide insights into the best way to care for patients with this common, multifactorial condition.

Published
2018
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9. Acute kidney injury and mild therapeutic hypothermia in patients after cardiopulmonary resuscitation - a post hoc analysis of a prospective observational trial

Author

Julia Hasslacher, Fabian Barbieri, Ulrich Harler, Hanno Ulmer, Lui G. Forni, Romuald Bellmann, and Michael Joannidis

Subjects
Acute kidney injury, Mild therapeutic hypothermia, Cardiopulmonary resuscitation, Neurological outcome, Cystatin C, Creatinine, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Abstract Background The aim of this study was to investigate the influence of mild therapeutic hypothermia (MTH) on the incidence of and recovery from acute kidney injury (AKI). Methods Patients who had undergone successful cardiopulmonary resuscitation (CPR) were included. Serum creatinine and cystatin C were measured at baseline, daily up to 5 days and at ICU discharge. AKI was defined by the Kidney Disease Improving Global Outcomes (KDIGO) criteria. MTH was applied for 24 h targeting a temperature of 33 °C. Neurological outcome was assessed with the Cerebral Performance Categories score at hospital discharge. Results 126 patients were included in the study; 73 patients (58%) developed AKI. Patients treated with MTH had a significantly lower incidence of AKI as compared to normothermia (NT) (44 vs. 69%; p = 0.004). Patients with less favourable neurological outcomes had a significantly higher rate of AKI, although when treated with MTH the occurrence of AKI was reduced (50 vs. 80%; p = 0.017). Furthermore, MTH treatment was accompanied by significantly lower creatinine levels on day 0–1 and at ICU discharge (day 0: 1.12 (0.90–1.29) vs. 1.29 (1.00–1.52) mg/dl; p = 0.016) and lower cystatin C levels on day 0–3 and at ICU discharge (day 0: 0.88 (0.77–1.10) vs. 1.29 (1.06–2.16) mg/l; p

Published
2018
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10. Blood pressure deficits in acute kidney injury: not all about the mean arterial pressure?

Author

Lui G. Forni and Michael Joannidis

Subjects
Blood pressure, Acute kidney injury, Blood pressure target, Relative hypotension, Perfusion pressure, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Abstract Acute kidney injury (AKI) is associated with increased morbidity and mortality. Although there are many causes of AKI, it is known that patients undergoing high-risk surgery are known to be at significant risk. Although much effort has centred on the minimum arterial pressure needed to maintain renal perfusion, this tends to be based on relatively crude measures such as the mean arterial pressure (MAP), which is widely used as an index for the optimal blood pressure. The rationale behind maintaining MAP is to provide adequate organ perfusion, although this is difficult to assess other than by applying crude end-points. Recent studies have examined the progression of AKI as defined by the KDIGO criteria in terms of time-weighted average values for premorbid and within-ICU haemodynamic pressure-related parameters. Although principally performed on patients who had undergone cardiovascular surgery and who were on vasopressor support, some interesting results were obtained suggesting that crude MAP may not be an adequate target in AKI. In patients with AKI progression, greater observed deficits in mean perfusion pressure, diastolic arterial perfusion, and diastolic perfusion pressures were observed. This study may highlight potential modifiable risk factors for the prevention of progression of AKI, and hopefully translate into improved outcomes.

Published
2017
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12. Cardiac and Vascular Surgery–Associated Acute Kidney Injury: The 20th International Consensus Conference of the ADQI (Acute Disease Quality Initiative) Group

Author

Mitra K. Nadim, Lui G. Forni, Azra Bihorac, Charles Hobson, Jay L. Koyner, Andrew Shaw, George J. Arnaoutakis, Xiaoqiang Ding, Daniel T. Engelman, Hrvoje Gasparovic, Vladimir Gasparovic, Charles A. Herzog, Kianoush Kashani, Nevin Katz, Kathleen D. Liu, Ravindra L. Mehta, Marlies Ostermann, Neesh Pannu, Peter Pickkers, Susanna Price, Zaccaria Ricci, Jeffrey B. Rich, Lokeswara R. Sajja, Fred A. Weaver, Alexander Zarbock, Claudio Ronco, and John A. Kellum

Subjects
biomarker, dialysis, diuretics, ischemia–reperfusion injury, renal insufficiency, Diseases of the circulatory (Cardiovascular) system, RC666-701
Published
2018
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14. The ICE-AKI study: Impact analysis of a Clinical prediction rule and Electronic AKI alert in general medical patients.

Author

Luke E Hodgson, Paul J Roderick, Richard M Venn, Guiqing L Yao, Borislav D Dimitrov, and Lui G Forni

Subjects
Medicine, Science
Abstract

BACKGROUND:Acute kidney injury (AKI) is assoicated with high mortality and measures to improve risk stratification and early identification have been urgently called for. This study investigated whether an electronic clinical prediction rule (CPR) combined with an AKI e-alert could reduce hospital-acquired AKI (HA-AKI) and improve associated outcomes. METHODS AND FINDINGS:A controlled before-and-after study included 30,295 acute medical admissions to two adult non-specialist hospital sites in the South of England (two ten-month time periods, 2014-16); all included patients stayed at least one night and had at least two serum creatinine tests. In the second period at the intervention site a CPR flagged those at risk of AKI and an alert was generated for those with AKI; both alerts incorporated care bundles. Patients were followed-up until death or hospital discharge. Primary outcome was change in incident HA-AKI. Secondary outcomes in those developing HA-AKI included: in-hospital mortality, AKI progression and escalation of care. On difference-in-differences analysis incidence of HA-AKI reduced (odds ratio [OR] 0.990, 95% CI 0.981-1.000, P = 0.049). In-hospital mortality in HA-AKI cases reduced on difference-in-differences analysis (OR 0.924, 95% CI 0.858-0.996, P = 0.038) and unadjusted analysis (27.46% pre vs 21.67% post, OR 0.731, 95% CI 0.560-0.954, P = 0.021). Mortality in those flagged by the CPR significantly reduced (14% pre vs 11% post intervention, P = 0.008). Outcomes for community-acquired AKI (CA-AKI) cases did not change. A number of process measures significantly improved at the intervention site. Limitations include lack of randomization, and generalizability will require future investigation. CONCLUSIONS:In acute medical admissions a multi-modal intervention, including an electronically integrated CPR alongside an e-alert for those developing HA-AKI improved in-hospital outcomes. CA-AKI outcomes were not affected. The study provides a template for investigations utilising electronically generated prediction modelling. Further studies should assess generalisability and cost effectiveness. TRIAL REGISTRATION:Clinicaltrials.org NCT03047382.

Published
2018
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19. Digital health and acute kidney injury: consensus report of the 27th Acute Disease Quality Initiative workgroup

Author

Kashani, Kianoush B., Awdishu, Linda, Bagshaw, Sean M., Barreto, Erin F., Claure-Del Granado, Rolando, Evans, Barbara J., Forni, Lui G., Ghosh, Erina, Goldstein, Stuart L., Kane-Gill, Sandra L., Koola, Jejo, Koyner, Jay L., Liu, Mei, Murugan, Raghavan, Nadkarni, Girish N., Neyra, Javier A., Ninan, Jacob, Ostermann, Marlies, Pannu, Neesh, Rashidi, Parisa, Ronco, Claudio, Rosner, Mitchell H., Selby, Nicholas M., Shickel, Benjamin, Singh, Karandeep, Soranno, Danielle E., Sutherland, Scott M., Bihorac, Azra, and Mehta, Ravindra L.

Published
2023
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20. Hemoadsorption

Author

Bellomo, Rinaldo, Mehta, Ravindra L., Forni, Lui G., Zarbock, Alexander, Ostermann, Marlies, Ronco, Claudio, Ankawi, Ghada, Bagshaw, Sean M., Baldwin, Ian, Basu, Rajit, Bottari, Gabriella, Cantaluppi, Vincenzo, Clark, William, De Rosa, Silvia, Forni, Lui G., Fuhrman, Dana, Gomez, Hernando, Husain-Syed, Faeq, Joannidis, Michael, Kashani, Kianoush, Lorenzin, Anna, Mehta, Ravindra, Murray, Patrick T., Murugan, Ragi, Ostermann, Marlies, Pannu, Neesh, Premuzic, Vedran, Prowle, John, Reis, Thiago, Rimmelé, Thomas, Rosner, Mitch, Schneider, Antoine, See, Emily, Soranno, Danielle, Villa, Gianluca, Whaley-Connell, Adam, and Zarbock, Alexander

Published
2024
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23. Statistical analysis plan for the biomarker-guided intervention to prevent acute kidney injury after major surgery (BigpAK-2) study: An international randomised controlled multicentre trial

Author

Wempe, Carola, Storck, Michael, Brix, Tobias, Strauss, Christian, Sadjadi, Mahan, Weiss, Raphael, Booke, Hendrik, Loomann, Lisa, Amini, Wida, Meschede, Dana, Göbel, Ulrich, Haaker, Jan Gerrit, Brenner, Thorsten, Espeter, Florian, Rahmel, Tim, Adamzik, Michael, Brandenburger, Timo, Putensen, Christian, Bode, Christian, Kruse, Philippe, Wild, Lennart, Rosenberger, Peter, Bernard, Alice, Jung-König, Mona, Larmann, Jan, Reutershan, Jörg, Arndt, Christian, Vojnar, Benjamin, Spieth, Peter M., Schneider, Antoine, Monard, Céline, Mura, Benedetta, Villa, Gianluca, Laici, Cristiana, Siniscalchi, Antonio, Capozzi, Chiara, Sita, Marco, Cattin, Lucia, de Rosa, Silvia, Spadaro, Savino, Franco, D'Arcangelo Benito, Ostermann, Marlies, Gossage, James, Verzelloni, Alessandra, Scaramuzzi, Marco, Glass, Adam, Silversides, Jon, Lonsdale, Elliot, Forni, Lui G., Haider, Syeda, Rossiter, Adam, Welters, Ingeborg, Hoste, Eric, Hollmann, Markus W., Ripollés-Melchor, Javier, Fernández-Valdes-Bango, Paula, Parise-Roux, Diego, Martin González, Maria Carmen, Bathal, Irene Romero, Jáuregui, Maider Puyada, Navarro-Perez, Rosalía, De Soto, Inés, García-Álvarez, Raquel, Sánchez, Elena Murcia, Suarez-de-la-Rica, Alejandro, Lalande, Robin, von Groote, Thilo, Danzer, Moritz Fabian, Meersch, Melanie, Zarbock, Alexander, and Gerß, Joachim

Published
2024
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25. Acute kidney injury

Author

Joannidis, Michael, Meersch-Dini, Melanie, and Forni, Lui G.

Subjects
Fresenius Medical Care AG & Company KGaA, Baxter Healthcare Corp., Medical colleges, Hospital patients, Kidney diseases, Health care industry
Abstract

Author(s): Michael Joannidis [sup.1], Melanie Meersch-Dini [sup.2], Lui G. Forni [sup.3] [sup.4] Author Affiliations: (1) grid.5361.1, 0000 0000 8853 2677, Division of Intensive Care and Emergency Medicine, Department of Internal [...]

Published
2023
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26. Sepsis-associated acute kidney injury: consensus report of the 28th Acute Disease Quality Initiative workgroup

Author

Zarbock, Alexander, Nadim, Mitra K., Pickkers, Peter, Gomez, Hernando, Bell, Samira, Joannidis, Michael, Kashani, Kianoush, Koyner, Jay L., Pannu, Neesh, Meersch, Melanie, Reis, Thiago, Rimmelé, Thomas, Bagshaw, Sean M., Bellomo, Rinaldo, Cantaluppi, Vicenzo, Deep, Akash, De Rosa, Silvia, Perez-Fernandez, Xose, Husain-Syed, Faeq, Kane-Gill, Sandra L., Kelly, Yvelynne, Mehta, Ravindra L., Murray, Patrick T., Ostermann, Marlies, Prowle, John, Ricci, Zaccaria, See, Emily J., Schneider, Antoine, Soranno, Danielle E., Tolwani, Ashita, Villa, Gianluca, Ronco, Claudio, and Forni, Lui G.

Published
2023
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27. Postoperative acute kidney injury in adult non-cardiac surgery: joint consensus report of the Acute Disease Quality Initiative and PeriOperative Quality Initiative

Author

Prowle, John R, Forni, Lui G, Bell, Max, Chew, Michelle S, Edwards, Mark, Grams, Morgan E, Grocott, Michael PW, Liu, Kathleen D, McIlroy, David, Murray, Patrick T, Ostermann, Marlies, Zarbock, Alexander, Bagshaw, Sean M, Bartz, Raquel, Bell, Samira, Bihorac, Azra, Gan, Tong J, Hobson, Charles E, Joannidis, Michael, Koyner, Jay L, Levett, Denny ZH, Mehta, Ravindra L, Miller, Timothy E, Mythen, Michael G, Nadim, Mitra K, Pearse, Rupert M, Rimmele, Thomas, Ronco, Claudio, Shaw, Andrew D, and Kellum, John A

Subjects
Prevention, Cardiovascular, Patient Safety, Clinical Research, Kidney Disease, Renal and urogenital, Good Health and Well Being, Acute Kidney Injury, Humans, Kidney, Postoperative Complications, Risk Factors, Clinical Sciences, Urology & Nephrology
Abstract

Postoperative acute kidney injury (PO-AKI) is a common complication of major surgery that is strongly associated with short-term surgical complications and long-term adverse outcomes, including increased risk of chronic kidney disease, cardiovascular events and death. Risk factors for PO-AKI include older age and comorbid diseases such as chronic kidney disease and diabetes mellitus. PO-AKI is best defined as AKI occurring within 7 days of an operative intervention using the Kidney Disease Improving Global Outcomes (KDIGO) definition of AKI; however, additional prognostic information may be gained from detailed clinical assessment and other diagnostic investigations in the form of a focused kidney health assessment (KHA). Prevention of PO-AKI is largely based on identification of high baseline risk, monitoring and reduction of nephrotoxic insults, whereas treatment involves the application of a bundle of interventions to avoid secondary kidney injury and mitigate the severity of AKI. As PO-AKI is strongly associated with long-term adverse outcomes, some form of follow-up KHA is essential; however, the form and location of this will be dictated by the nature and severity of the AKI. In this Consensus Statement, we provide graded recommendations for AKI after non-cardiac surgery and highlight priorities for future research.

Published
2021

28. Regional Practice Variation and Outcomes in the Standard Versus Accelerated Initiation of Renal Replacement Therapy in Acute Kidney Injury (STARRT-AKI) Trial: A Post Hoc Secondary Analysis

Author

Vaara, Suvi T., Serpa Neto, Ary, Bellomo, Rinaldo, Adhikari, Neill K. J., Dreyfuss, Didier, Gallagher, Martin, Gaudry, Stephane, Hoste, Eric, Joannidis, Michael, Pettilä, Ville, Wang, Amanda Y., Kashani, Kianoush, Wald, Ron, Bagshaw, Sean M., Ostermann, Marlies, Bagshaw, Sean M, Wald, Ron, Adhikari, Neill K.J., Bellomo, Rinaldo, Dreyfuss, Didier, Du, Bin, Gallagher, Martin P., Gaudry, Stéphane, Hoste, Eric A., Lamontagne, François, Joannidis, Michael, Liu, Kathleen D., McAuley, Daniel F., McGuinness, Shay P., Nichol, Alistair D., Ostermann, Marlies, Palevsky, Paul M., Qiu, Haibo, Pettilä, Ville, Schneider, Antoine G., Smith, Orla M., Vaara, Suvi T., Weir, Matthew, Bellomo, Rinaldo, Eastwood, Glenn M., Peck, Leah, Young, Helen, Kruger, Peter, Laurie, Gordon, Saylor, Emma, Meyer, Jason, Venz, Ellen, Wetzig, Krista, French, Craig, McGain, Forbes, Mulder, John, Fennessy, Gerard, Koottayi, Sathyajith, Bates, Samantha, Towns, Miriam, Morgan, Rebecca, Tippett, Anna, Udy, Andrew, Mason, Chris, Licari, Elisa, Gantner, Dashiell, McClure, Jason, Nichol, Alistair, McCracken, Phoebe, Board, Jasmin, Martin, Emma, Vallance, Shirley, Young, Meredith, Vladic, Chelsey, McGloughlin, Steve, Gattas, David, Buhr, Heidi, Coles, Jennifer, Hutch, Debra, Wun, James, Cole, Louise, Whitehead, Christina, Lowrey, Julie, Masters, Kristy, Gresham, Rebecca, Campbell, Victoria, Gutierrez, David, Brailsford, Jane, Forbes, Loretta, Murray, Lauren, Maguire, Teena, NiChonghaile, Martina, Orford, Neil, Bone, Allison, Elderkin, Tania, Salerno, Tania, Chimunda, Tim, Fletcher, Jason, Broadfield, Emma, Porwal, Sanjay, Knott, Cameron, Boschert, Catherine, Smith, Julie, Richardson, Angus, Hill, Dianne, Duke, Graeme, Oziemski, Peter, Cegarra, Santiago, Chan, Peter, Welsh, Deborah, Hunter, Stephanie, Roodenburg, Owen, Dyett, John, Kokotsis, Nicos, Moser, Max, Yang, Yang, Padayachee, Laven, Vetro, Joseph, Gangopadhyay, Himangsu, Kaufman, Melissa, Ghosh, Angaj, Said, Simone, Patel, Alpesh, Bihari, Shailesh, Matheson, Elisha, Jin, Xia, Shrestha, Tapaswi, Schwartz, Kate, Gallagher, Martin P., Cross, Rosalba, Cheung, Winston, Wong, Helen, Kol, Mark, Shah, Asim, Wang, Amanda Y., Endre, Zoltan, Bradford, Celia, Janin, Pierre, Finfer, Simon, Diel, Naomi, Gatward, Jonathan, Hammond, Naomi, Delaney, Anthony, Bass, Frances, Yarad, Elizabeth, Buscher, Hergen, Reynolds, Claire, Baker, Nerilee, Joannidis, Michael, Bellmann, Romuald, Peer, Andreas, Hasslacher, Julia, Koglberger, Paul, Klein, Sebastian, Zotter, Klemens, Brandtner, Anna, Finkenstedt, Armin, Ditlbacher, Adelheid, Hartig, Frank, Fries, Dietmar, Bachler, Mirjam, Schenk, Bettina, Wagner, Martin, Staudinger, Thomas, Tiller, Esther, Schellongowski, Peter, Bojic, Andja, Hoste, Eric A., Bracke, Stephanie, De Crop, Luc, Vermeiren, Daisy, Thome, Fernando, Chiella, Bianca, Fendt, Lucia, Antunes, Veronica, Maisonneuve-Rosemont, Lafrance, Jean-Philippe, Lamontagne, François, D’Aragon, Frédérick, St-Arnaud, Charles, Mayette, Michael, Carbonnaeu, Élaine, Marchand, Joannie, Masse, Marie-Hélène, Ladouceur, Marilène, Turgeon, Alexis F., Lauzier, François, Bellemare, David, Langis Francoeur, Charles, LeBlanc, Guillaume, Guilbault, Gabrielle, Grenier, Stéphanie, Cloutier, Eve, Boivin, Annick, Delisle-Thibault, Charles, Giannakouros, Panagiota, Costerousse, Olivier, Cailhier, Jean-François, Carrier, François-Martin, Ghamraoui, Ali, Lebrasseur, Martine, Benettaib, Fatna, Salamé, Maya, Boumahni, Dounia, Tung Sia, Ying, Naud, Jean-François, Roy, Isabelle, Stelfox, Henry T., Ruddell, Stacey, Manns, Braden J., Duggan, Shelley, Carney, Dominic, Barchard, Jennifer, Whitlock, Richard P., Belley-Cote, Emilie, Savija, Nevena, Sabev, Alexandra, Campbell, Troy, Creary, Thais, Devereaux, Kelson, Brodutch, Shira, Rigatto, Claudio, Paunovic, Bojan, Mooney, Owen, Glybina, Anna, Harasemiw, Oksana, Di Nella, Michelle, Harmon, John, Mehta, Navdeep, Lakatos, Louis, Haslam, Nicole, Lellouche, Francois, Simon, Mathieu, Tung, Ying, Lizotte, Patricia, Bourchard, Pierre-Alexandre, Rochwerg, Bram, Karachi, Tim, Millen, Tina, Muscedere, John, Maslove, David, Gordon Boyd, J., Sibley, Stephanie, Drover, John, Hunt, Miranda, Georgescu, Ilinca, Wax, Randy, Lenga, Ilan, Sridhar, Kavita, Steele, Andrew, Fusco, Kelly, Ghate, Taneera, Tolibas, Michael, Robinson, Holly, Weir, Matthew A., Taneja, Ravi, Ball, Ian M., Garg, Amit, Campbell, Eileen, Ovsenek, Athena, Bagshaw, Sean M., van Diepen, Sean, Baig, Nadia, Magder, Sheldon, Yao, Han, Alam, Ahsan, Campisi, Josie, MacIntyre, Erika, Rokosh, Ella, Scherr, Kimberly, Lapinsky, Stephen, Mehta, Sangeeta, Shah, Sumesh, Niven, Daniel J., Stelfox, Henry T., Ruddell, Stacey, Russell, Michael, Jim, Kym, Brown, Gillian, Oxtoby, Kerry, Hall, Adam, Benoit, Luc, Sokolowski, Colleen, Prasad, Bhanu, Rao, Jag, Giebel, Shelley, Kutsogiannis, Demetrios J., Thompson, Patricia, Thompson, Tayne, Cirone, Robert, Kavikondala, Kanthi, Soth, Mark, Clarke, France, Takaoka, Alyson, Wald, Ron, Mazer, David, Burns, Karen, Friedrich, Jan, Klein, David, Sandhu, Gyan, Santos, Marlene, Khalid, Imrana, Hodder, Jennifer, Dodek, Peter, Ayas, Najib, Alcuaz, Victoria, Suen, Gabriel, Rewa, Oleksa, Singh, Gurmeet, Norris, Sean, Gibson, Neil, Arias, Castro, Shami, Aysha, Pelletier, Celine, Adhikari, Neill K.J., Zahirieh, Alireza, Amaral, Andre, Marinoff, Nicole, Kaur, Navjot, Perez, Adic, Wang, Jane, Haljan, Gregory, Condin, Christopher, McIntyre, Lauralyn, Gomes, Brigette, Porteous, Rebecca, Watpool, Irene, Hiremath, Swapnil, Clark, Edward, Herridge, Margaret S., Backhouse, Felicity, Elizabeth Wilcox, M., Walczak, Karolina, Ki, Vincent, Sharman, Asheer, Romano, Martin, Bagshaw, Sean M., Noel Gibney, R.T., Romanovsky, Adam S., Rewa, Oleksa, McCoshen, Lorena, Baig, Nadia, Wood, Gordon, Ovakim, Daniel, Auld, Fiona, Carney, Gayle, Duan, Meili, Ji, Xiaojun, Guo, Dongchen, Qi, Zhili, Lin, Jin, Zhang, Meng, Dong, Lei, Liu, Jingfeng, Liu, Pei, Zhi, Deyuan, Bai, Guoqiang, Qiu, Yu, Yang, Ziqi, Bai, Jing, Liu, Zhuang, Zhuang, Haizhou, Wang, Haiman, Li, Jian, Zhao, Mengya, Zhou, Xiao, Shi, Xianqing, Ye, Baning, Liu, Manli, Wu, Jing, Fu, Yongjian, Long, Dali, Pan, Yu, Wang, Jinlong, Mei, Huaxian, Zhang, Songsong, Wen, Mingxiang, Yang, Enyu, Mu, Sijie, Li, Jianquan, Hu, Tingting, Qin, Bingyu, Li, Min, Wang, Cunzhen, Dong, Xin, Wang, Kaiwu, Wang, Haibo, Yang, Jianxu, Du, Bin, Wang, Chuanyao, Wang, Dongxin, Li, Nan, Yu, Zhui, Xu, Song, Yao, Lan, Hou, Guo, Liu, Zhou, Lu, Liping, Lian, Yingtao, Wang, Chunting, Zhang, Jichen, Ding, Ruiqi, Qi, Guoqing, Wang, Qizhi, Wang, Peng, Meng, Zhaoli, Chen, Man, Hu, Xiaobo, He, Xiandi, Zhao, Shibing, Hang, Lele, Li, Rui, Qin, Suhui, Lu, Kun, Dun, Shijuan, Liu, Cheng, Zhou, Qi, Chen, Zhenzhen, Mei, Jing, Zhang, Minwei, Xu, Hao, Lin, Jincan, Shi, Qindong, Fu, Lijuan, Zeng, Qinjing, Ma, Hongye, Yan, Jinqi, Gao, Lan, Liu, Hongjuan, Zhang, Lei, Li, Hao, He, Xiaona, Fan, Jingqun, Guo, Litao, Liu, Yu, Wang, Xue, Sun, Jingjing, Liu, Zhongmin, Yang, Juan, Ding, Lili, Sheng, Lulu, Liu, Xingang, Yan, Jie, Wang, Quihui, Wang, Yifeng, Zhao, Dan, Zhao, Shuangping, Hu, Chenghuan, Li, Jing, Deng, Fuxing, Qiu, Haibo, Yang, Yi, Mo, Min, Pan, Chun, Wu, Changde, Huang, Yingzi, Huang, Lili, Liu, Airan, Pettilä, Ville, Vaara, Suvi T., Korhonen, Anna-Maija, Törnblom, Sanna, Sutinen, Sari, Pettilä, Leena, Heinonen, Jonna, Lappi, Eliria, Suhonen, Taria, Karlsson, Sari, Hoppu, Sanna, Jalkanen, Ville, Kuitunen, Anne, Levoranta, Markus, Långsjö, Jaakko, Ristimäki, Sanna, Malila, Kaisa, Wootten, Anna, Varila, Simo, Järvisalo, Mikko J, Inkinen, Outi, Kentala, Satu, Leivo, Keijo, Haltia, Paivi, Dreyfuss, Didier, Ricard, Jean-Damien, Messika, Jonathan, Tiagarajah, Abirami, Emery, Malo, Dechanet, Aline, Gernez, Coralie, Roux, Damien, Martin-Lefevre, Laurent, Fiancette, Maud, Vinatier, Isabelle, Claude Lacherade, Jean, Colin, Gwenhaël, Lebert, Christine, Azais, Marie-Ange, Yehia, Aihem, Pouplet, Caroline, Henry- Lagarrigue, Matthieu, Seguin, Amélie, Crosby, Laura, Maizel, Julien, Titeca-Beauport, Dimitri, Combes, Alain, Nieszkowska, Ania, Masi, Paul, Demoule, Alexandre, Mayaux, Julien, Dres, Martin, Morawiec, Elise, Decalvele, Maxens, Demiri, Suela, Faure, Morgane, Marios, Clémence, Mallet, Maxime, Amélie Ordon, Marie, Morizot, Laura, Cantien, Marie, Pousset, François, Gaudry, Stéphane, Poirson, Florent, Cohen, Yves, Argaud, Laurent, Cour, Martin, Bitker, Laurent, Simon, Marie, Hernu, Romain, Baudry, Thomas, De La Salle, Sylvie, Robine, Adrien, Sedillot, Nicholas, Tchenio, Xavier, Bouisse, Camille, Roux, Sylvie, Barbar, Davide, Trusson, Rémi, Tamion, Fabienne, Grangé, Steven, Carpentier, Dorothée, Chevrel, Guillaume, Ensenyat-Martin, Luis, Marque, Sophie, Quenot, Jean-Pierre, Andreu, Pascal, Dargent, Auguste, Large, Audrey, Chudeau, Nicolas, Landais, Mickael, Derrien, Benoit, Christophe Callahan, Jean, Guitton, Christophe, Le Moal, Charlène, Robert, Alain, Asehnoune, Karim, Cinotti, Raphaël, Grillot, Nicolas, Demeure, Dominique, Vinsonneau, Christophe, Rahmani, Imen, Marzouk, Mehdi, Dekeyser, Thibault, Sejourne, Caroline, Verlay, Mélanie, Thevenin, Fabienne, Delecolle, Lucie, Didier Thevenin, Lens, Souweine, Bertrand, Coupez, Elisabeth, Adda, Mireille, Eraldi, Jean-Pierre, Marchalot, Antoine, De Prost, Nicolas, Mekontso Dessap, Armand, Razazi, Keyvan, Meziani, Ferhat, Boisrame-Helms, Julie, Clere-Jehl, Raphael, Delabranche, Xavier, Kummerlen, Christine, Merdji, Hamid, Monnier, Alexandra, Rabouel, Yannick, Rahmani, Hassene, Allam, Hayat, Chenaf, Samir, Franja, Vincenta, Pons, Bertrand, Carles, Michel, Martino, Frédéric, Richard, Régine, Zuber, Benjamin, Lacave, Guillaume, Lakhal, Karim, Rozec, Bertrand, Dang Van, Hoa, Boulet, Éric, Dubos, René, Fadel, Fouad, Cleophax, Cedric, Dufour, Nicolas, Grant, Caroline, Thuong, Marie, Reignier, Jean, Canet, Emmanuel, Nicolet, Laurent, Boulain, Thierry, Nay, Mai-Anh, Benzekri, Dalila, Barbier, François, Bretagnol, Anne, Kamel, Toufik, Mathonnet, Armelle, Muller, Grégoire, Skarzynski, Marie, Rossi, Julie, Pradet, Amandine, Dos Santos, Sandra, Guery, Aurore, Muller, Lucie, Felix, Luis, Bohé, Julien, Thiéry, Guillaume, Aissaoui, Nadia, Vimpere, Damien, Commeureuc, Morgane, Diehl, Jean-Luc, Guerot, Emmanuel, Liangos, Orfeas, Wittig, Monika, Zarbock, Alexander, Küllmar, Mira, van Waegeningh, Thomas, Rosenow, Nadine, Nichol, Alistair D., Brickell, Kathy, Doran, Peter, Murray, Patrick T., Landoni, Giovanni, Lembo, Rosalba, Zangrillo, Alberto, Monti, Giacomo, Tozzi, Margherita, Marzaroli, Matteo, Lombardi, Gaetano, Paternoster, Gianluca, Vitiello, Michelangelo, McGuinness, Shay, Parke, Rachael, Butler, Magdalena, Gilder, Eileen, Cowdrey, Keri-Anne, Wallace, Samantha, Hallion, Jane, Woolett, Melissa, Neal, Philippa, Duffy, Karina, Long, Stephanie, McArthur, Colin, Simmonds, Catherine, Chen, Yan, McConnochie, Rachael, Newby, Lynette, Knight, David, Henderson, Seton, Mehrtens, Jan, Morgan, Stacey, Morris, Anna, Vander Hayden, Kymbalee, Burke, Tara, Bailey, Matthew, Freebairn, Ross, Chadwick, Lesley, Park, Penelope, Rolls, Christine, Thomas, Liz, Buehner, Ulrike, Williams, Erin, Albrett, Jonathan, Kirkham, Simon, Jackson, Carolyn, Browne, Troy, Goodson, Jennifer, Jackson, David, Houghton, James, Callender, Owen, Higson, Vicki, Keet, Owen, Dominy, Clive, Young, Paul, Hunt, Anna, Judd, Harriet, Lawrence, Cassie, Olatunji, Shaanti, Robertson, Yvonne, Latimer-Bell, Charlotte, Hendry, Deborah, Mckay-Vucago, Agnes, Beehre, Nina, Lesona, Eden, Navarra, Leanlove, Robinson, Chelsea, Jang, Ryan, Junge, Andrea, Lambert, Bridget, Schneider, Antoine G., Thibault, Michel, Eckert, Philippe, Kissling, Sébastien, Polychronopoulos, Erietta, Poli, Elettra, Altarelli, Marco, Schnorf, Madeleine, Abed Mallaird, Samia, Heidegger, Claudia, Perret, Aurelie, Montillier, Philippe, Sangla, Frederic, Neils, Seigenthaller, De Watteville, Aude, Phull, Mandeep-Kaur, George, Aparna, Hussain, Nauman, Pogreban, Tatiana, Lobaz, Steve, Daniels, Alison, Cunningham, Mishell, Kerr, Deborah, Nicholson, Alice, Shanmugasundaram, Pradeep, Abrams, Judith, Manso, Katarina, Hambrook, Geraldine, McKerrow, Elizabeth, Salva, Juvy, Foulkes, Stephen, Wise, Matthew, Morgan, Matt, Brooks, Jenny, Cole, Jade, Michelle Davies, Tracy, Hill, Helen, Thomas, Emma, Vizcaychipi, Marcela, Baharlo, Behrad, Carungcong, Jaime, Costa, Patricia, Martins, Laura, Kapoor, Ritoo, Hazelton, Tracy, Moon, Angela, Musselwhite, Janine, Shelley, Ben, McCall, Philip, Ostermann, Marlies, Arbane, Gill, Bociek, Aneta, Marotti, Martina, Lim, Rosario, Campos, Sara, Grau Novellas, Neus, Cennamo, Armando, Slack, Andrew, Wyncoll, Duncan, Camporota, Luigi, Sparkes, Simon, Tilley, Rosalinde, Rattray, Austin, Moreland, Gayle, Duffy, Jane, McGonigal, Elizabeth, Hopkins, Philip, Finney, Clare, Smith, John, Noble, Harriet, Watson, Hayley, Harris, Claire-Louise, Clarey, Emma, Corcoran, Eleanor, Beck, James, Howcroft, Clare, Youngs, Nora, Wilby, Elizabeth, Ogg, Bethan, Wolverson, Adam, Lee, Sandra, Butler, Susie, Okubanjo, Maryanne, Hindle, Julia, Welters, Ingeborg, Williams, Karen, Johnson, Emily, Patrick-Heselton, Julie, Shaw, David, Waugh, Victoria, Stewart, Richard, Mwaura, Esther, Wren, Lynn, Mew, Louise, Sutherland, Sara-Beth, Adderley, Jane, Ruddy, Jim, Harkins, Margaret, Kaye, Callum, Scott, Teresa, Mitchell, Wendy, Anderson, Felicity, Willox, Fiona, Jagannathan, Vijay, Clark, Michele, Purv, Sarah, Sharman, Andrew, Meredith, Megan, Ryan, Lucy, Conner, Louise, Peters, Cecilia, Harvey, Dan, Roshdy, Ashraf, Collins, Amy, Sim, Malcolm, Henderson, Steven, Chee, Nigel, Pitts, Sally, Bowman, Katie, Dilawershah, Maria, Vamplew, Luke, Howe, Elizabeth, Rogers, Paula, Hernandez, Clara, Prendergast, Clara, Benton, Jane, Rosenberg, Alex, Forni, Lui G., Grant, Alice, Carvelli, Paula, Raithatha, Ajay, Bird, Sarah, Richardson, Max, Needham, Matthew, Hirst, Claire, Ball, Jonathan, Leaver, Susannah, Howlett, Luisa, Castro Delgado, Carlos, Farnell-Ward, Sarah, Farrah, Helen, Gray, Geraldine, Joseph, Gipsy, Robinson, Francesca, Tridente, Ascanio, Harrop, Clare, Shuker, Karen, McLaughlan, Derek, Ramsey, Judith, Meehan, Sharon, Oliver Rose, Bernd, Reece-Anthony, Rosie, Gurung, Babita, Whitehouse, Tony, Snelson, Catherine, Veenith, Tonny, Johnston, Andy, Cooper, Lauren, Carrera, Ron, Ellis, Karen, Fellows, Emma, Harkett, Samanth, Bergin, Colin, Spruce, Elaine, Despy, Liesl, Goundry, Stephanie, Dooley, Natalie, Mason, Tracy, Clark, Amy, Dignam, Gemma, Ward, Geraldine, Attwood, Ben, Parsons, Penny, Mason, Sophie, Margarson, Michael, Lord, Jenny, McGlone, Philip, Hodgson, Luke E., Chadbourn, Indra, Gomez, Raquel, Margalef, Jordi, Pretorius, Rinus, Hamshere, Alexandra, Carter, Joseph, Cahill, Hazel, Grainger, Lia, Howard, Kate, Forshaw, Greg, Guy, Zoe, Kashani, Kianoush B., Albright, Robert C., Amsbaugh, Amy, Stoltenberg, Anita, Niven, Alexander S., Lynch, Matthew, O’Mara, AnnMarie, Naeem, Syed, Sharif, Sairah, McKenney Goulart, Joyce, Lynch, Matthew, O’Mara, AnnMarie, Naeem, Syed, Sharif, Sairah, McKenney Goulart, Joyce, Tolwani, Ashita, Lyas, Claretha, Latta, Laura, Bihorac, Azra, Hashemighouchani, Haleh, Efron, Philip, Ruppert, Matthew, Cupka, Julie, Kiley, Sean, Carson, Joshua, White, Peggy, Omalay, George, Brown, Sherry, Velez, Laura, Marceron, Alina, Neyra, Javier A., Carlos Aycinena, Juan, Elias, Madona, Ortiz-Soriano, Victor M., Hauschild, Caroline, and Dorfman, Robert

Published
2024
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31. Publisher Correction: COVID-19-associated acute kidney injury: consensus report of the 25th Acute Disease Quality Initiative (ADQI) Workgroup

Author

Nadim, Mitra K, Forni, Lui G, Mehta, Ravindra L, Connor, Michael J, Liu, Kathleen D, Ostermann, Marlies, Rimmelé, Thomas, Zarbock, Alexander, Bell, Samira, Bihorac, Azra, Cantaluppi, Vincenzo, Hoste, Eric, Husain-Syed, Faeq, Germain, Michael J, Goldstein, Stuart L, Gupta, Shruti, Joannidis, Michael, Kashani, Kianoush, Koyner, Jay L, Legrand, Matthieu, Lumlertgul, Nuttha, Mohan, Sumit, Pannu, Neesh, Peng, Zhiyong, Perez-Fernandez, Xose L, Pickkers, Peter, Prowle, John, Reis, Thiago, Srisawat, Nattachai, Tolwani, Ashita, Vijayan, Anitha, Villa, Gianluca, Yang, Li, Ronco, Claudio, and Kellum, John A

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Renal and urogenital, Good Health and Well Being, Urology & Nephrology, Clinical sciences
Abstract

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Published
2020

32. COVID-19-associated acute kidney injury: consensus report of the 25th Acute Disease Quality Initiative (ADQI) Workgroup

Author

Nadim, Mitra K, Forni, Lui G, Mehta, Ravindra L, Connor, Michael J, Liu, Kathleen D, Ostermann, Marlies, Rimmelé, Thomas, Zarbock, Alexander, Bell, Samira, Bihorac, Azra, Cantaluppi, Vincenzo, Hoste, Eric, Husain-Syed, Faeq, Germain, Michael J, Goldstein, Stuart L, Gupta, Shruti, Joannidis, Michael, Kashani, Kianoush, Koyner, Jay L, Legrand, Matthieu, Lumlertgul, Nuttha, Mohan, Sumit, Pannu, Neesh, Peng, Zhiyong, Perez-Fernandez, Xose L, Pickkers, Peter, Prowle, John, Reis, Thiago, Srisawat, Nattachai, Tolwani, Ashita, Vijayan, Anitha, Villa, Gianluca, Yang, Li, Ronco, Claudio, and Kellum, John A

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Prevention, Kidney Disease, Renal and urogenital, Good Health and Well Being, Acute Kidney Injury, Anticoagulants, COVID-19, Consensus, Humans, Renal Replacement Therapy, Risk Factors, SARS-CoV-2, Urology & Nephrology, Clinical sciences
Abstract

Kidney involvement in patients with coronavirus disease 2019 (COVID-19) is common, and can range from the presence of proteinuria and haematuria to acute kidney injury (AKI) requiring renal replacement therapy (RRT; also known as kidney replacement therapy). COVID-19-associated AKI (COVID-19 AKI) is associated with high mortality and serves as an independent risk factor for all-cause in-hospital death in patients with COVID-19. The pathophysiology and mechanisms of AKI in patients with COVID-19 have not been fully elucidated and seem to be multifactorial, in keeping with the pathophysiology of AKI in other patients who are critically ill. Little is known about the prevention and management of COVID-19 AKI. The emergence of regional 'surges' in COVID-19 cases can limit hospital resources, including dialysis availability and supplies; thus, careful daily assessment of available resources is needed. In this Consensus Statement, the Acute Disease Quality Initiative provides recommendations for the diagnosis, prevention and management of COVID-19 AKI based on current literature. We also make recommendations for areas of future research, which are aimed at improving understanding of the underlying processes and improving outcomes for patients with COVID-19 AKI.

Published
2020

33. Renin and Survival in Patients Given Angiotensin II for Catecholamine-Resistant Vasodilatory Shock. A Clinical Trial

Author

Bellomo, Rinaldo, Forni, Lui G, Busse, Laurence W, McCurdy, Michael T, Ham, Kealy R, Boldt, David W, Hästbacka, Johanna, Khanna, Ashish K, Albertson, Timothy E, Tumlin, James, Storey, Kristine, Handisides, Damian, Tidmarsh, George F, Chawla, Lakhmir S, and Ostermann, Marlies

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Hypertension, Cardiovascular, Clinical Research, Clinical Trials and Supportive Activities, Evaluation of treatments and therapeutic interventions, 6.1 Pharmaceuticals, Aged, Angiotensin II, Biomarkers, Catecholamines, Female, Humans, Male, Middle Aged, Predictive Value of Tests, Renin, Shock, Vasoconstrictor Agents, angiotensin I, renin-angiotensin-aldosterone system, distributive shock, angiotensin-converting enzyme defect, renin–angiotensin–aldosterone system, Medical and Health Sciences, Respiratory System, Cardiovascular medicine and haematology, Clinical sciences
Abstract

Rationale: Exogenous angiotensin II increases mean arterial pressure in patients with catecholamine-resistant vasodilatory shock (CRVS). We hypothesized that renin concentrations may identify patients most likely to benefit from such therapy.Objectives: To test the kinetic changes in renin concentrations and their prognostic value in patients with CRVS.Methods: We analyzed serum samples from patients enrolled in the ATHOS-3 (Angiotensin II for the Treatment of High-Output Shock) trial for renin, angiotensin I, and angiotensin II concentrations before the start of administration of angiotensin II or placebo and after 3 hours.Measurements and Main Results: Baseline serum renin concentration (normal range, 2.13-58.78 pg/ml) was above the upper limits of normal in 194 of 255 (76%) study patients with a median renin concentration of 172.7 pg/ml (interquartile range [IQR], 60.7 to 440.6 pg/ml), approximately threefold higher than the upper limit of normal. Renin concentrations correlated positively with angiotensin I/II ratios (r = 0.39; P

Published
2020

34. Quality of Care for Acute Kidney Disease: Current Knowledge Gaps and Future Directions

Author

Liu, Kathleen D, Forni, Lui G, Heung, Michael, Wu, Vin-Cent, Kellum, John A, Mehta, Ravindra L, Ronco, Claudio, Kashani, Kianoush, Rosner, Mitchell H, Haase, Michael, Koyner, Jay L, Investigators, Acute Disease Quality Initiative, and Mehta, Ravi

Subjects
Health Services and Systems, Biomedical and Clinical Sciences, Clinical Sciences, Health Sciences, Kidney Disease, Clinical Research, Patient Safety, Renal and urogenital, Good Health and Well Being, acute kidney injury, outcomes, quality, recovery, Acute Disease Quality Initiative Investigators, Biomedical and clinical sciences, Health sciences
Abstract

Acute kidney injury (AKI) and acute kidney disease (AKD) are common complications in hospitalized patients and are associated with adverse outcomes. Although consensus guidelines have improved the care of patients with AKI and AKD, guidance regarding quality metrics in the care of patients after an episode of AKI or AKD is limited. For example, few patients receive follow-up laboratory testing of kidney function or post-AKI or AKD care through nephrology or other providers. Recently, the Acute Disease Quality Initiative developed a consensus statement regarding quality improvement goals for patients with AKI or AKD specifically highlighting efforts regarding quality and safety of care after hospital discharge after an episode of AKI or AKD. The goal is to use these measures to identify opportunities for improvement that will positively affect outcomes. We recommend that health care systems quantitate the proportion of patients who need and actually receive follow-up care after the index AKI or AKD hospitalization. The intensity and appropriateness of follow-up care should depend on patient characteristics, severity, duration, and course of AKI of AKD, and should evolve as evidence-based guidelines emerge. Quality indicators for discharged patients with dialysis requiring AKI or AKD should be distinct from end-stage renal disease measures. Besides, there should be specific quality indicators for those still requiring dialysis in the outpatient setting after AKI or AKD. Given the limited preexisting data guiding the care of patients after an episode of AKI or AKD, there is ample opportunity to establish quality measures and potentially improve patient care and outcomes. This review will provide specific evidence-based and expert opinion-based guidance for the care of patients with AKI or AKD after hospital discharge.

Published
2020

35. Controversies in acute kidney injury: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Conference

Author

Ostermann, Marlies, Bellomo, Rinaldo, Burdmann, Emmanuel A, Doi, Kent, Endre, Zoltan H, Goldstein, Stuart L, Kane-Gill, Sandra L, Liu, Kathleen D, Prowle, John R, Shaw, Andrew D, Srisawat, Nattachai, Cheung, Michael, Jadoul, Michel, Winkelmayer, Wolfgang C, Kellum, John A, Participants, Conference, Bagshaw, Sean M, Barreto, Erin F, Bihorac, Azra, Bobek, Ilona, Bouchard, Josée, Cerdá, Jorge, Chakravarthi, Rajasekara, De Rosa, Silvia, Engelman, Daniel T, Forni, Lui G, Hemmilä, Ulla K, Herzog, Charles A, Hoste, Eric A, Huen, Sarah C, Iseki, Kunitoshi, Joannidis, Michael, Kashani, Kianoush B, Koyner, Jay L, Kribben, Andreas, Lameire, Norbert, Levey, Andrew S, Macedo, Etienne, Małyszko, Jolanta, Meersch, Melanie, Mehta, Ravindra L, Mewburn, Irene, Mironova, Olga, Murray, Patrick T, Nadim, Mitra K, Pan, Jenny S, Pannu, Neesh, Peng, Zhiyong, Philips, Barbara, Ponce, Daniela, Ray, Patricio E, Ricci, Zaccaria, Rimmelé, Thomas, Ronco, Claudio, Siew, Edward D, Stevens, Paul E, Tolwani, Ashita J, Tonelli, Marcello, Vaara, Suvi T, van Dam, Marjel, Vijayan, Anitha, Wise, Michael, Wu, Vin-Cent, and Zarbock, Alexander

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Kidney Disease, 7.3 Management and decision making, Management of diseases and conditions, Renal and urogenital, Acute Kidney Injury, Humans, acute kidney disease, acute kidney injury, fluid management, nephrotoxicity, renal replacement therapy, risk stratification, Conference Participants, Urology & Nephrology, Clinical sciences
Abstract

In 2012, Kidney Disease: Improving Global Outcomes (KDIGO) published a guideline on the classification and management of acute kidney injury (AKI). The guideline was derived from evidence available through February 2011. Since then, new evidence has emerged that has important implications for clinical practice in diagnosing and managing AKI. In April of 2019, KDIGO held a controversies conference entitled Acute Kidney Injury with the following goals: determine best practices and areas of uncertainty in treating AKI; review key relevant literature published since the 2012 KDIGO AKI guideline; address ongoing controversial issues; identify new topics or issues to be revisited for the next iteration of the KDIGO AKI guideline; and outline research needed to improve AKI management. Here, we present the findings of this conference and describe key areas that future guidelines may address.

Published
2020

39. Serial Urinary C-C Motif Chemokine Ligand 14 and Risk of Persistent Severe Acute Kidney Injury

Author

Prowle, John R., Artigas, Antonio, Bagshaw, Sean M., Forni, Lui G., Heung, Michael, Hoste, Eric, Marlies, Ostermann, Koyner, Jay L., Chawla, Lakmir, Kampf, J. Patrick, Kwan, Thomas, McPherson, Paul, Kellum, John A., Kashani, K, Al-Khafaji, A, Ardiles, T, Artigas, A, Bagshaw, SM, Bell, M, Bihorac, A, Birkhahn, R, Cely, CM, Chawla, LS, Davison, D, Feldkamp, T, Forni, LG, Gong, MN, Gunnerson, KJ, Haase, M, Hackett, J, Honore, P, Hoste, EAJ, Joannes-Boyau, O, Joannidis, M, Kim, P, Koyner, JL, Laskowitz, DT, Lissauer, ME, Marx, G, McCullough, PA, Mullaney, S, Ostermann, M, Rimmele, T, Shapiro, NI, Shaw, AD, Shi, J, Walker, MG, Sprague, AM, Vincent, JL, Vinsonneau, C, Wagner, L, Wilkerson, RG, Zacharowski, K, Kellum, JA, Hoste, Eric, Bihora, Azra, Al-Khafaji, Ali, Ortega, Luis M., Ostermann, Marlies, Haase, Michael, Zacharowski, Kai, Wunderink, Richard, Heung, Michael, Gunnerson, Kyle, Lissauer, Matthew, Herr, Daniel, Self, Wesley H., Koyner, Jay L., Honore, Patrick M., Prowle, John R., Davison, Danielle, Artigas, Antonio, Joannidis, Michael, Schroeder, Rebecca, Demirjian, Sevag, Forni, Lui G., Hodgson, Luke, Wilber, Scott T., Frey, Jennifer A., Reilly, Ian, Shi, Jing, Patrick Kampf, J., Kwan, Thomas, McPherson, Paul, Kellum, John A., and Chawla, Lakhmir S.

Published
2023
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42. The AKI care bundle: all bundle components are created equal-are they?

Author

von Groote, Thilo C., Ostermann, Marlies, Forni, Lui G., Meersch-Dini, Melanie, Zarbock, Alexander, Schmidt, Christoph, and Hoffmeier, Andreas

Subjects
Acute renal failure -- Care and treatment, Hemodynamic monitoring -- Methods, Medical protocols -- Evaluation, Critically ill -- Care and treatment, Health care industry
Abstract

Author(s): Thilo C. von Groote [sup.1] , Marlies Ostermann [sup.2] , Lui G. Forni [sup.3] [sup.4] , Melanie Meersch-Dini [sup.1] , Alexander Zarbock [sup.1] , Christoph Schmidt, Andreas Hoffmeier, Hugo [...]

Published
2022
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43. Cardiac and Vascular Surgery–Associated Acute Kidney Injury: The 20th International Consensus Conference of the ADQI (Acute Disease Quality Initiative) Group

Author

Nadim, Mitra K, Forni, Lui G, Bihorac, Azra, Hobson, Charles, Koyner, Jay L, Shaw, Andrew, Arnaoutakis, George J, Ding, Xiaoqiang, Engelman, Daniel T, Gasparovic, Hrvoje, Gasparovic, Vladimir, Herzog, Charles A, Kashani, Kianoush, Katz, Nevin, Liu, Kathleen D, Mehta, Ravindra L, Ostermann, Marlies, Pannu, Neesh, Pickkers, Peter, Price, Susanna, Ricci, Zaccaria, Rich, Jeffrey B, Sajja, Lokeswara R, Weaver, Fred A, Zarbock, Alexander, Ronco, Claudio, and Kellum, John A

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Good Health and Well Being, Acute Kidney Injury, Cardiac Surgical Procedures, Consensus Development Conferences as Topic, Humans, Quality Improvement, Vascular Surgical Procedures, biomarker, dialysis, diuretics, ischemia-reperfusion injury, renal insufficiency, ischemia–reperfusion injury, Cardiorespiratory Medicine and Haematology, Cardiovascular medicine and haematology
Published
2018

44. Hemoadsorption: Consensus report of the 30th Acute Disease Quality Initiative workgroup

Author

Ankawi, Ghada, primary, Bagshaw, Sean M, additional, Bellomo, Rinaldo, additional, Baldwin, Ian, additional, Basu, Rajit, additional, Bottari, Gabriella, additional, Cantaluppi, Vincenzo, additional, Clark, William, additional, De Rosa, Silvia, additional, Forni, Lui G, additional, Fuhrman, Dana, additional, Goldstein, Stuart, additional, Gomez, Hernando, additional, Husain-Syed, Faeq, additional, Joannidis, Michael, additional, Kashani, Kianoush, additional, Lorenzin, Anna, additional, Mehta, Ravindra, additional, Murray, Patrick T, additional, Murugan, Ragi, additional, Ostermann, Marlies, additional, Pannu, Neesh, additional, Premuzic, Vedran, additional, Prowle, John, additional, Reis, Thiago, additional, Rimmelé, Thomas, additional, Ronco, Claudio, additional, Rosner, Mitch, additional, Schneider, Antoine, additional, See, Emily, additional, Soranno, Danielle, additional, Villa, Gianluca, additional, Whaley-Connell, Adam, additional, and Zarbock, Alexander, additional

Published
2024
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47. Assessing the role of Chemokine (C–C motif) ligand 14 in AKI: a European consensus meeting.

Author

Koyner, Jay L., Arndt, Christian, Baldira Martinez de Irujo, Jaume, Coelho, Sílvia, Garcia-Montesinos de la Peña, Manuel, di Girolamo, Luca, Joannidis, Michael, Jorge-Monjas, Pablo, Koch, Christian, Lobaz, Steven, Meyer, Alain, Ostermann, Marlies, Pertica, Nicoletta, Prowle, John R., Silversides, Jon, Zarbock, Alexander, Echeverri, Jorge, Harenski, Kai, and Forni, Lui G.

Subjects
ACUTE kidney failure, RENAL replacement therapy, LIKERT scale
Abstract

Urinary Chemokine (C–C motif) ligand 14 (CCL14) is a biomarker associated with persistent severe acute kidney injury (AKI). There is limited data to support the implementation of this AKI biomarker to guide therapeutic actions. Sixteen AKI experts with clinical CCL14 experience participated in a Delphi-based method to reach consensus on when and how to potentially use CCL14. Consensus was defined as ≥ 80% agreement (participants answered with 'Yes', or three to four points on a five-point Likert Scale). Key consensus areas for CCL14 test implementation were: identifying challenges and mitigations, developing a comprehensive protocol and pairing it with a treatment plan, and defining the target population. The majority agreed that CCL14 results can help to prioritize AKI management decisions. CCL14 levels above the high cutoff (> 13 ng/mL) significantly changed the level of concern for modifying the AKI treatment plan (p < 0.001). The highest level of concern to modify the treatment plan was for discussions on renal replacement therapy (RRT) initiation for CCL14 levels > 13 ng/mL. The level of concern for discussion on RRT initiation between High and Low, and between Medium and Low CCL14 levels, showed significant differences. Real world urinary CCL14 use appears to provide improved care options to patients at risk for persistent severe AKI. Experts believe there is a role for CCL14 in AKI management and it may potentially reduce AKI-disease burden. There is, however, an urgent need for evidence on treatment decisions and adjustments based on CCL14 results. [ABSTRACT FROM AUTHOR]

Published
2024
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49. "Renal": The First Forbidden Word in the Medical Lexicon.

Author

Bellomo, Rinaldo, Kellum, John A., Reis, Thiago, Forni, Lui G., and Ronco, Claudio

Subjects
MEDICAL language, SCIENTIFIC communication, RENAL replacement therapy, MEDICAL periodicals, SCIENTIFIC literature, MEDICAL literature, NEPHROLOGISTS
Abstract

This document discusses the controversy surrounding the use of the word "renal" in medical literature. Some journals have started to demand that the word be replaced with "kidney" in an effort to make articles more understandable to patients. However, many physicians argue that this policy is misguided and undermines academic freedom. They believe that the medical literature should facilitate communication among physicians worldwide and that it is not the purview of English-speaking journals to dictate changes in the global medical lexicon. The authors encourage researchers to choose journals that respect academic freedom and not submit their work to journals that enforce this language control. [Extracted from the article]

Published
2024
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50. CCL14 Predicts Oliguria and Dialysis Requirement in Patients with Moderate to Severe Acute Kidney Injury.

Author

Demirjian, Sevag, Chawla, Lakhmir, Davison, Danielle, Forni, Lui G., Heung, Michael, Hoste, Eric A.J., Koyner, Jay, Kampf, J. Patrick, Kwan, Thomas, McPherson, Paul, and Kellum, John A.

Subjects
ACUTE kidney failure, HEMODIALYSIS patients, LOGISTIC regression analysis, REGRESSION analysis, CRITICALLY ill
Abstract

Introduction: AKI is a frequent complication of critical illness and portends poor outcome. CCL14 is a validated predictor of persistent severe AKI in critically ill patients. We examined the association of CCL14 with urine output within 48 h. Methods: In pooled data from 2 studies of critically ill patients with KDIGO stage 2–3 AKI, CCL14 was measured by NEPHROCLEAR™ CCL14 Test on the Astute 140® Meter (low, intermediate, and high categories [1.3 and 13 ng/mL]). Average hourly urine output over 48 h, stage 3 AKI per urine output criterion on day 2, and composite of dialysis or death within 7 days were examined using multivariable mixed and logistic regression models. Results: Of the 497 subjects with median age of 65 (56–74) years, 49% (242/497) were on diuretics. CCL14 concentration was low in 219 (44%), intermediate in 217 (44%), and high in 61 (12%) patients. In mixed regression analysis, hourly urine output over time was different within each CCL14 risk category based on diuretic use due to significant three-way interaction (p < 0.001). In logistic regression analysis, CCL14 risk category was independently associated with low urine output on day 2 per KDIGO stage 3 (adjusted for diuretic use and baseline clinical variables), and composite of dialysis or death within 7 days (adjusted for urine output within 48 h of CCL14 measurement). Conclusions: CCL14 measured in patients with moderate to severe AKI is associated with urine output trajectory within 48 h, oliguria on day 2, and dialysis within 7 days. [ABSTRACT FROM AUTHOR]

Published
2024
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