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Improving the quality of neonatal acute kidney injury care: neonatal-specific response to the 22nd Acute Disease Quality Initiative (ADQI) conference

Journal of Perinatology volume 41, pages 185–195 (2021)Cite this article

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Abstract

With the adoption of standardized neonatal acute kidney injury (AKI) definitions over the past decade and the concomitant surge in research studies, the epidemiology of and risk factors for neonatal AKI have become much better understood. Thus, there is now a need to focus on strategies designed to improve AKI care processes with the goal of reducing the morbidity and mortality associated with neonatal AKI. The 22nd Acute Dialysis/Disease Quality Improvement (ADQI) report provides a framework for such quality improvement in adults at risk for AKI and its sequelae. While many of the concepts can be translated to neonates, there are a number of specific nuances which differ in neonatal AKI care. A group of experts in pediatric nephrology and neonatology came together to provide neonatal-specific responses to each of the 22nd ADQI consensus statements.

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Fig. 1: ABCD evaluation and 4Ms.
Fig. 2: Quality improvement methodology.

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Acknowledgements

We acknowledge Drs. Ravi Mehta, John Kellum, and Claudio Ronco for their leadership and vision in leading the ADQI collaborative. Furthermore, we are indebted to all of the members of the 22nd ADQI meeting who worked together to develop and articulate the importance of quality improvement in the field of AKI.

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Authors and Affiliations

  1. Division of Neonatology, Department of Pediatrics, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA

    Matthew W. Harer

  2. Department of Pediatric, Medical University of South Carolina, Charleston, SC, USA

    David T. Selewski

  3. Division of Nephrology and Hypertension, Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN, USA

    Kianoush Kashani

  4. Children’s Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA, USA

    Rajit K. Basu

  5. Department of Pediatrics, Children’s Hospital Colorado, University of Colorado Anschutz Medical Campus Aurora, Aurora, CO, USA

    Katja M. Gist

  6. Division of Nephrology, Dialysis and Transplantation, Stead Family Department of Pediatrics, University of Iowa, Iowa City, IA, USA

    Jennifer G. Jetton

  7. Division of Nephrology, Department of Pediatrics, Stanford University, Stanford, CA, USA

    Scott M. Sutherland

  8. Division of Nephrology, Department of Pediatrics, Toronto Hospital for Sick Children, Toronto, ON, Canada

    Michael Zappitelli

  9. Center for Acute Care Nephrology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Stuart L. Goldstein

  10. Department of Pediatrics, Texas Children’s Hospital, Houston, TX, USA

    Theresa Ann Mottes

  11. Department of Pediatrics, University of Alabama Birmingham, Birmingham, AL, USA

    David J. Askenazi

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All authors have participated in the concept and design; analysis and interpretation of data; drafting and revising of the manuscript, and they have approved the manuscript as submitted here.

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Correspondence to Matthew W. Harer.

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Conflict of interest

The authors have no quality improvement related conflicts of interest to report that would have affected the writing of this publication. For AKI-related research, MZ is a member of the AKI adjudication committee for an industry sponsored study on NGAL as an AKI biomarker (Bioporto Inc.) DJA is consultant for Baxter, CHF solutions, Bioporo, and Medtronic. RKB is a consultant for Baxter, Biomerieux and BioPorto.

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Harer, M.W., Selewski, D.T., Kashani, K. et al. Improving the quality of neonatal acute kidney injury care: neonatal-specific response to the 22nd Acute Disease Quality Initiative (ADQI) conference. J Perinatol 41, 185–195 (2021). https://doi.org/10.1038/s41372-020-00810-z

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