The Acute Dialysis Quality Initiative II: the Vicenza conference

Abstract

A large number of patients develop acute renal failure in the intensive care unit and nephrology wards, and mortality remains high. In recent years, there have been considerable advances in our understanding and technical capabilities, but consensus over the optimal way to diagnose and treat acute renal failure does not exist. Consequently, a consensus conference under the auspices of the Acute Dialysis Quality Initiative (ADQI) has been held in Vicenza in the year 2002 after the previous conference held in New York in the year 2000. The ADQI aims at establishing an evidence-based appraisal and set of consensus recommendations to standardize care and direct further research. The first of these conferences held in June 2000 in New York focused on continuous renal replacement therapy (CRRT). The reports from this first consensus conference are now available online at www.ADQI.net and are also published in part in this issue. However, there remains a need for consensus in several other areas of acute renal failure. Acute renal failure has no accepted definition or rather there are over 30 definitions used in the literature and no consensus as to which one should be used. Studies designed to prevent or treat acute renal failure often use clinical and physiologic endpoints that are not comparable to other studies making it difficult to compare the results of one study to another. Finally, the success of multicentered clinical trials in supportive care in the intensive care unit (transfusion thresholds and ventilator management) have intensified and renewed interest in the study of supportive care methods as a major target for future research. These developments have set the stage for the first conference and have now driven the spirit of the second. Once again, the final objectives are the development of evidence-based guidelines and directions for future research.