Acute renal failure – definition, outcome measures, animal models, fluid therapy and information technology needs: the Second International Consensus Conference of the Acute Dialysis Quality…

By R. Bellomo, C. Ronco, John A. Kellum, R. Mehta, P. Palevsky. Critical Care, 2004

1,583 citations recorded by the source corpus.

IntroductionThere is no consensus definition of acute renal failure (ARF) in critically ill patients. More than 30 different definitions have been used in the literature, creating much confusion and making comparisons difficult. Similarly, strong debate exists on the validity and clinical relevance of animal models of ARF; on choices of fluid management and of end-points for trials of new interventions in this field; and on how information technology can be used to assist this process. Accordingly, we sought to review the available evidence, make recommendations and delineate key questions for future studies.MethodsWe undertook a systematic review of the literature using Medline and PubMed searches. We determined a list of key questions and convened a 2-day consensus conference to develop summary statements via a series of alternating breakout and plenary sessions. In these sessions, we identified supporting evidence and generated recommendations and/or directions for future research.ResultsWe found sufficient consensus on 47 questions to allow the development of recommendations. Importantly, we were able to develop a consensus definition for ARF. In some cases it was also possible to issue useful consensus recommendations for future investigations. We present a summary of the findings. (Full versions of the six workgroups' findings are available on the internet at http://www.ADQI.net)ConclusionDespite limited data, broad areas of consensus exist for the physiological and clinical principles needed to guide the development of consensus recommendations for defining ARF, selection of animal models, methods of monitoring fluid therapy, choice of physiological and clinical end-points for trials, and the possible role of information technology.

Subfields: Epidemiology, Nephrology, Surgery

View Paper: https://www.semanticscholar.org/paper/e9f39bf3949ca853c8a771e55ff4699209f6ca48

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In Epidemiology

1. John A. Kellum
2. Claudio Ronco
3. R. Bellomo
4. Sean M. Bagshaw
5. Derek C. Angus
6. R. Mehta

In Nephrology

1. John A. Kellum
2. Claudio Ronco
3. R. Bellomo
4. Sean M. Bagshaw
5. L. Chawla
6. V. Vaidya
7. M. Ferguson
8. N. Lameire

In Surgery

1. R. Bellomo
2. Claudio Ronco
3. John A. Kellum
4. L. Chawla
5. Sean M. Bagshaw
6. A. Levin
7. Carol George

Citations in the corpus

• Acute kidney injury (2012, background): “[2] Acute renal failure is usually additionally classified according to the location of the predominant primary pathology (prerenal, intrarenal, and postrenal failure).”
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• Effect of Individualized vs Standard Blood Pressure Management Strategies on Postoperative Organ Dysfunction Among High-Risk Patients Undergoing Major Surgery: A Randomized Clinical Trial (2017, neutral): “End of intervention period 120 (22) 110 (19) <.”
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• Diagnosis, evaluation, and management of acute kidney injury: a KDIGO summary (Part 1) (2013, background): “Th e Acute Dialysis Quality Initiative group developed the Risk, Injury, Failure; Loss and End-stage kidney disease (RIFLE) system for diagnosis and classifi cation of a broad range of acute impairment of kidney function through a broad consensus of experts [8].”
• Hepatorenal syndrome: the 8th international consensus conference of the Acute Dialysis Quality Initiative (ADQI) Group (2012, methodology): “Table 4 The Acute Dialysis Quality Initiative (ADQI) criteria for the definition and classification of acute kidney injury (modified RIFLE criteria) [41,43]”
• An assessment of the RIFLE criteria for acute renal failure in hospitalized patients* (2006, methodology): “Recently, ADQI published a consensus definition of ARF, using a set of criteria called the RIFLE (Risk, Injury, Failure, Loss, and End stage) criteria (9).”
• Modified RIFLE criteria in critically ill children with acute kidney injury. (2007, methodology): “KEYWORDS: acute renal failure; children; critical illness; epidemiology More than 30 acute kidney injury (AKI) definitions exist in the published literature.(1) Lack of a standardized definition that can be applied across patient populations (1) impedes rational comparison of studies that assess pre”
• RIFLE criteria for acute kidney injury are associated with hospital mortality in critically ill patients: a cohort analysis (2006, background): “RIFLE represents a new classification system issued from a process of formal evidence appraisal and expert opinion [11,12].”