Research Horizons


Global Panel Addresses Lack of Care Standards for Children with Acute Kidney Injury

Nephrology | Top Scientific Achievement
2023 Research Discoveries

With acute kidney injury (AKI) occurring more frequently among children and leading to chronic kidney disease and other adverse outcomes, a panel of 46 global experts convened in 2021 at the first international pediatric AKI conference to assess the state-of-the-art and address the lack of child-fo­cused care standards for the field.

A year later, the Pediatric ADQI Collaborative published its consensus recommendations, which featured Stuart Goldstein, MD, director of the Center for Acute Care Nephrol­ogy at Cincinnati Children’s, as first author.

“Many factors about acute kidney injury are unique to children,” Goldstein says. “But care standards across the country have been based primarily upon adult care. This consensus statement recognizes that achieving better outcomes for children will require quality improvement across many fronts, from diagnostics to therapeutics to nutrition.” Recommendations include:

  • A call for more AKI epidemiologic data from non-intensive care unit and ambulatory settings, in low-middle income countries, and for socioeconomic and long-term outcomes.
  • Urging development of validated tools for AKI risk stratifica­tion and diagnosis that account for unique AKI phenotypes in children. Improved fluid assessment practices.
  • Support for multidisciplinary teams to provide coordinated kidney support and extracorporeal therapies, and involve patients and families more directly in decision-making.
  • Prioritizing research to measure child development after AKI.
  • More education and advocacy to highlight the long-term risks associated with AKI in children.

Seven additional papers that go into detail about the recommendations from the six pADQI work groups will appear in a single issue of the journal Pediatric Nephrology in 2024, Goldstein says.

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Publication Information
Original title: Consensus-Based Recommendations on Priority Activities to Address Acute Kidney Injury in Children: A Modified Delphi Consensus Statement
Published in: JAMA Network Open
Publish date: Sept. 1, 2022
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Research By

Stuart Goldstein, MD
Stuart Goldstein, MD
Director, Center for Acute Care Nephrology

My research is focused on short- and long-term outcomes for children who have AKI and those who are at risk for AKI.