Development of a clinical research agenda for acute kidney injury using an international, interdisciplinary, three-step modified Delphi process.
OBJECTIVE
Although acute kidney injury is common and significantly increases the risk for intensive care unit and hospital mortality, little is known about its true incidence or how it can be prevented. Furthermore, key unanswered questions remain about the optimal diagnosis and treatment of patients with acute kidney injury. An international, consensus-based, prioritized research agenda was sought to guide clinical and translational research in acute kidney injury.


METHODS
A three-step modified Delphi process involving 43 participants representing 19 professional societies, organizations, and multiple stakeholder groups ranging from clinical practice to basic science research was conducted.


RESULTS
Twenty research questions were generated across six focus groups. Overall, research priorities generated from nephrologists and intensivists were similar and highly correlated. The stakeholder groups included members from 15 countries. Results from adult and pediatric groups showed important differences, as did results from developing compared with developed countries; however the priority rankings from the developed and developing countries were significantly correlated. Top research priorities in acute kidney injury include determining optimal timing of renal replacement therapy and improving the understanding of the epidemiology of acute kidney injury around the world.


CONCLUSIONS
Research recommendations that are highly consistent across various stakeholder groups and between developed and developing countries have been produced. It is hoped that these recommendations will prove valuable in guiding future clinical and translational research in this area.
Kellum
John A
JA
Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Scaife Hall, Room 608, 3550 Terrace Street, Pittsburgh, PA 15261, USA. kellumja@ccm.upmc.edu
Mehta
Ravindra L
RL
Levin
Adeera
A
Molitoris
Bruce A
BA
Warnock
David G
DG
Shah
Sudhir V
SV
Joannidis
Michael
M
Ronco
Claudio
C
D058186:Acute Kidney Injury / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D000328:Adult; D035843:Biomedical Research / Q000458:organization & administration*; D002648:Child; D003697:Delphi Technique; D019049:Developed Countries; D003906:Developing Countries; D017144:Focus Groups; D006801:Humans; D033183:Interdisciplinary Communication; D007391:International Cooperation; D016730:Program Development; D017582:Renal Replacement Therapy / Q000592:standards