Evidence map›Paper›PMID 42095908›Full record

SynthesisPediatric nephrology (Berlin, Germany)2026

Key performance indicators for acute kidney replacement therapy in critically ill children: a systematic review.

Prit Kusirisin, Kristin J Dolan, Rashid Alobaidi, Dana Y Fuhrman, Aadil K Kakajiwala, Tara M Neumayr, Ahmed S Said, Janice Y Kung, Ayse Akcan Arikan, Oleksa G Rewa

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Pediatric nephrology (Berlin, Germany), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Prit KusirisinDepartment of Critical Care Medicine, Faculty of Medicine and Dentistry, Critical Care Medicine, University of Alberta, and Alberta Health Services, 2-124E Clinical Sciences Building, 8440 112 St NW, Edmonton, AB, T6G 2B7, Canada.
Kristin J DolanDivision of Critical Care Medicine, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA.
Rashid AlobaidiDivision of Pediatric Critical Care, Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.
Dana Y FuhrmanDivision of Critical Care Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Aadil K KakajiwalaDepartment of Pediatrics, Nephrology, George Washington University, Children's National Hospital, Washington DC, USA.
Tara M NeumayrDepartment of Pediatrics, Critical Care, Washington University School of Medicine, St. Louis Children's Hospital, St. Louis, MO, USA.
Ahmed S SaidDepartment of Pediatrics, Critical Care, Washington University School of Medicine, St. Louis Children's Hospital, St. Louis, MO, USA.
Janice Y KungGeoffrey & Robyn Sperber Health Sciences Library, University of Alberta, Edmonton, AB, Canada.
Ayse Akcan ArikanDivision of Critical Care Medicine, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA.
Oleksa G RewaDepartment of Critical Care Medicine, Faculty of Medicine and Dentistry, Critical Care Medicine, University of Alberta, and Alberta Health Services, 2-124E Clinical Sciences Building, 8440 112 St NW, Edmonton, AB, T6G 2B7, Canada. rewa@ualberta.ca.ORCID http://orcid.org/0000-0002-8718-0547

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAcute kidney injury is common among critically ill children and independently associated with morbidity and mortality, particularly in those receiving kidney replacement therapy (KRT). As KRT is not innocuous, standardizing its delivery is critical for accurate outcome tracking. Establishing key performance indicators (KPIs) is essential to guide quality improvement and support decision-making through ongoing monitoring of KRT processes.

objectivesThis systematic review evaluated existing evidence on KPIs related to KRT delivery in critically ill pediatric populations. DATA SOURCES: A comprehensive search of Ovid MEDLINE, Ovid Embase, CINAHL, and the Cochrane Library was conducted for studies published from inception to February 2025. STUDY ELIGIBILITY CRITERIA: Eligible studies reported KPIs related to dialysis processes in critically ill children receiving KRT. PARTICIPANTS AND

interventionsCritically ill children receiving all KRT modalities were assessed for KPIs according to the Donabedian framework, with each KPI stratified based on whether it measured a process related to KRT care. STUDY APPRAISAL AND SYNTHESIS

methodsSix reviewers independently screened, selected, and appraised studies using the risk-of-bias tool appropriate for each study design. Data were summarized narratively.

resultsOf 7,111 citations screened, 107 studies met inclusion criteria, comprising 57 retrospective cohorts, 27 case series, 16 prospective cohorts, 4 case reports, 2 randomized controlled trials, and 1 audit. Most studies (66.7%) were of moderate quality. Six KPIs were identified across 240 instances: solute clearance (n = 59), filter life (n = 52), downtime (n = 43), fluid management (n = 36), hypotension (n = 25), and prescription (n = 24). KPI definitions were heterogeneous. KPIs were categorized as important (n = 242, 52.1%), scientifically acceptable (n = 107, 23.1%), and feasible (n = 115, 24.8%). LIMITATIONS: This systematic review is limited by heterogeneity in study quality, with most evidence derived from observational or clinical studies rather than structured quality improvement initiatives. CONCLUSIONS AND IMPLICATIONS OF KEY

findingsMultiple potential KPIs for pediatric KRT were identified; however, definitions and validation were inconsistent. Standardizing and prioritizing a set of concise KPIs are needed to measure, benchmark, and improve KRT quality in critically ill children. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42023474374 (October 30, 2023).

Indexed as

Acute Kidney InjuryCritical IllnessQuality Indicators, Health CareRenal Replacement TherapyChildHumansQuality ImprovementAcute kidney injuryCritical careDialysisKey performance indicatorKidney replacement therapyPediatric

Identifiers

PMID42095908

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.