Table 5 |.

Summary points from the Acute Kidney Injury Controversies Conference

	Risk assessment	Diagnosis of AKI	Fluid management	Hemodynamic management	Drug stewardship	RRT
Consensus	• Need for risk models tailored to clinical context	• Retention of KDIGO criteria but there is need for refinement (i.e., duration, etiology, course, role of biomarkers, definition and staging of AKD)	• Importance of adequate hydration and correction of hypovolemia to prevent and treat AKI	• Importance of adequate renal perfusion to prevent and treat AKI	• Importance of drug stewardship in preventing and managing AKI • Retention of term “nephrotoxic” despite varying effects of drugs on kidney function	• Need for patient-centered communication • Need to tailor RRT to the condition of the patient
Evidence of importance but lack of consensus	• Role of new AKI risk models • Need for additional endpoints beyond mortality and CKD • Impact of renal reserve • Follow-up strategy after AKI	• Definition of “pre-clinical” AKI • Assessment of baseline kidney function • Evaluation of urine output • Definition of renal recovery • Role of kidney biopsy and new imaging techniques	• Definition and assessment of fluid overload • Impact of saline in different clinical settings • Role of goal-directed therapy in different clinical scenarios • Strategy of fluid removal	• Role of goal-directed therapy in different clinical scenarios • Impact of vasopressor type on kidney function	• Impact of contrast in different clinical settings • Role of ACE-Is/ARBs in AKI	• Assessment of recovery after RRT, including kidney function and patient-centered outcomes • Combination of RRT and other forms of extracorporeal organ support • Identification of quality indicators for acute RRT
Key topics for future research	• Evaluation of AKI risk models • Identification of clinical endpoints	• Role of real-time or kinetic GFR • Impact of body composition on AKI criteria	• Determination of optimal indications, fluid type, administration, and clinical endpoints of fluid therapy in AKI • Investigation of fluid-removal strategies	• Determination of optimal indications, vasopressor type, and clinical endpoints of fluid therapy in AKI	• Development of new classification describing renal effects of drugs • Role of biomarkers and electronic clinical decision-support systems • Management of ACE-Is/ARBs in AKI	• Determination of optimal fluid-removal strategy • Integration of RRT and other forms of extracorporeal support

ACE-I, angiotensin-converting enzyme inhibitor; AKD, acute kidney diseases and disorders; AKI, acute kidney injury; ARB, angiotensin-receptor blocker; CKD, chronic kidney disease; GFR, glomerular filtration rate; KDIGO, Kidney Disease: Improving Global Outcomes; RRT, renal replacement therapy.