Lui Forni United Kingdom

Lui Forni
Professor Lui Forni trained in intensive care and nephrology at St Thomas’ and St George’s Hospitals. He was appointed Professor of Intensive Care Medicine at the Royal Surrey Hospital NHS Foundation Trust in 2014 and joined the new School of Medicine at the University of Surrey in 2023. A founding member of the AKI section of ESICM, he went on to chair the group, later serving as Chair of Research and then Secretary of the Society. He is currently President-Elect of the International Society of Critical Care Nephrology. His research interests all aspects of acute kidney injury and renal replacement therapy. Professor Forni has also advised NCEPOD, been a faculty member for ADQI, contributed to the NHS England “Think Kidneys” programme, served as an elected member of the Faculty of Intensive Care Medicine, and remains an active member of the UK AKI Clinical Studies Group. He remains cursed by his support of Tottenham Hotspur and lack of musical ability obvious when you hear him play guitar. Or sing.

18th September 2026 Friday

Time Session
13:30
15:30
  • Ashita TolwaniUnited States Speaker The ABC of the CRRT PrescriptionPrescribing continuous renal replacement therapy requires an understanding of how modality, blood flow, treatment dose, replacement-fluid delivery, and circuit factors influence therapy delivery. This presentation will provide a practical framework for developing and evaluating a CRRT prescription, including the principles of diffusive and convective clearance, prescribed versus delivered dose, and the impact of replacement-fluid location and treatment interruptions. Clinical examples will highlight common prescribing challenges and demonstrate how CRRT settings can be adjusted to meet changing patient needs while maintaining effective and safe therapy.AnticoagulationEffective anticoagulation is essential to maintain circuit patency, minimize blood loss, and ensure delivery of the prescribed CRRT dose. This presentation will review the principles guiding anticoagulant selection during CRRT, including the relative roles of regional citrate anticoagulation, unfractionated heparin, and alternative agents. Particular emphasis will be placed on balancing circuit longevity with patient safety, recognizing patients at increased risk for bleeding or citrate intolerance, and monitoring for metabolic and anticoagulation-related complications. Dysnatremia and Acid-Base DisordersContinuous renal replacement therapy can be adapted to safely manage severe sodium and acid–base disturbances. This presentation will review a practical approach to modifying the CRRT prescription based on the patient’s serum sodium, acid–base status, and desired rate of correction. Emphasis will be placed on anticipating how CRRT solutions and treatment settings influence biochemical changes and on avoiding overly rapid correction or treatment-related complications. Clinical examples will illustrate key principles for individualized therapy.Managing Patients With Combined Kidney and Liver Failure
    Manish KaushikSingapore Speaker Patient Selection, Modality, DoseAccess, Membrane, CircuitSevere Hypernatremia and Hyperkalemia in AKI Requiring KRTPrecision Solute Control and Dynamic Dosing with CRRT
  • Balazs Szamosfalvi Speaker Optimizing Regional Citrate Anticoagulation with MultiFiltrate PRO: Protocol Selection and Management of Challenging PatientsAKI During ECMO: Is It a Consequence, a Complication, or a Modifiable Target?
    Lui ForniUnited Kingdom Speaker Sepsis Associated AKIBicarbonate in AKI: Use and MisuseAdapting CRRT for Patients with Electrolyte and ACID-Base Disorders
Room 101C
16:00
17:00
(Vantive)
Ashita TolwaniUnited States Moderator The ABC of the CRRT PrescriptionPrescribing continuous renal replacement therapy requires an understanding of how modality, blood flow, treatment dose, replacement-fluid delivery, and circuit factors influence therapy delivery. This presentation will provide a practical framework for developing and evaluating a CRRT prescription, including the principles of diffusive and convective clearance, prescribed versus delivered dose, and the impact of replacement-fluid location and treatment interruptions. Clinical examples will highlight common prescribing challenges and demonstrate how CRRT settings can be adjusted to meet changing patient needs while maintaining effective and safe therapy.AnticoagulationEffective anticoagulation is essential to maintain circuit patency, minimize blood loss, and ensure delivery of the prescribed CRRT dose. This presentation will review the principles guiding anticoagulant selection during CRRT, including the relative roles of regional citrate anticoagulation, unfractionated heparin, and alternative agents. Particular emphasis will be placed on balancing circuit longevity with patient safety, recognizing patients at increased risk for bleeding or citrate intolerance, and monitoring for metabolic and anticoagulation-related complications. Dysnatremia and Acid-Base DisordersContinuous renal replacement therapy can be adapted to safely manage severe sodium and acid–base disturbances. This presentation will review a practical approach to modifying the CRRT prescription based on the patient’s serum sodium, acid–base status, and desired rate of correction. Emphasis will be placed on anticipating how CRRT solutions and treatment settings influence biochemical changes and on avoiding overly rapid correction or treatment-related complications. Clinical examples will illustrate key principles for individualized therapy.Managing Patients With Combined Kidney and Liver Failure
Shih-Chi KuTaiwan Moderator
Room 101AB
17:10
18:00
  • 守護腎臟機能:高品質 CRRT 提升恢復率並減輕長期透析負擔之臨床探討
    Chih-Hsiang ChangTaiwan Speaker 重塑生命韌性:從 ICU 治療到回歸社會的康復之路急性腎損傷的照護目標不應止於 ICU 存活或成功脫離連續性腎臟替代治療(CRRT),而應延伸至腎功能恢復、身體功能重建與重返家庭及社會。高品質 CRRT 是此一照護路徑的起點,包括適切的治療時機與劑量、血流動力學穩定、液體管理、抗凝策略及治療中斷監測,以降低治療相關傷害並提升腎臟恢復機會。然而,出院後追蹤中斷、急性腎損傷病程辨識不足及跨專業資訊斷裂,仍使患者面臨慢性腎臟病、長期透析、再住院及功能衰退的風險。因此,台灣應建立從 ICU 延伸至社區的急性腎損傷整合照護政策:以標準化品質指標確保 CRRT 治療品質;透過電子警示、風險分層與跨院資料串接辨識高風險患者;並於出院後整合腎臟功能、藥物、營養、復健及病人報告結果的追蹤。最終政策成效不僅應評估死亡率與透析依賴,更應納入腎功能恢復、再住院、生活品質及重返社會,將急性期救命治療轉化為可衡量、可持續的生命韌性照護。
  • 從血液淨化邁向多器官支持療法,以品質指標、治療成效監測與真實世界資料最佳化重症預後之臨床實踐
    Yen-Ta HuangTaiwan Speaker From Guidelines to Bayesian Trials: How Should We Interpret Polymyxin B Hemoadsorption in Sepsis?Polymyxin B hemoadsorption has occupied an unusually contested place in sepsis care, and the way authoritative bodies describe it has shifted over time. This talk traces that evolution—from the 2020 Taiwan AKI consensus through the 2021 and 2026 Surviving Sepsis Campaign guidelines—and uses the changing recommendations as a lens on the methodological debates that underlie them. From an evidence-based medicine standpoint, the controversy is less about the device than about how we generate and grade evidence. I will first examine the frequentist evidence base, including our network meta-analysis of blood purification therapies for severe infection and sepsis/septic shock published in Critical Care Medicine. I will outline what a network meta-analysis adds—coherent ranking across multiple modalities, indirect comparison, and explicit quantification of heterogeneity—while being candid about its limitations, including reliance on the transitivity assumption, sparse networks, and the fragility of mortality estimates pooled from heterogeneous trials. I will then turn to the recently reported TIGRIS trial, which used a Bayesian, enrichment-based phase 3 design with prespecified borrowing from the EUPHRATES treatable cohort. I will highlight the strengths of the Bayesian presentation—direct posterior probabilities of benefit, transparent incorporation of prior evidence, and efficiency in a rare, mechanistically defined phenotype—alongside the cautions it demands: sensitivity to prior choice, the open-label design, and the gap between a high posterior probability and a confirmed effect. Bringing these strands together, the talk offers a multifaceted, methodology-driven reading of polymyxin B hemoadsorption in sepsis, and a transferable framework for clinicians facing the increasingly common situation in which guidelines, frequentist syntheses, and Bayesian trials appear to diverge.從治療執行到品質治理:連結式重症腎臟照護與資料驅動決策
  • Lui ForniUnited Kingdom Speaker Sepsis Associated AKIBicarbonate in AKI: Use and MisuseAdapting CRRT for Patients with Electrolyte and ACID-Base Disorders
    Shih-Chi KuTaiwan Moderator
  • 「急性腎損傷照護數位提升共同宣言」 持續優化器官支持治療與連續性照護品質,攜手推動台灣腎臟與重症醫療體系之穩健與長遠發展
Room 101AB

19th September 2026 Saturday

Time Session
10:45
12:30
Chi-yuan HsuUnited States Moderator Targeting Persistent AKI and Promoting RecoveryDoes Mild to Moderate AKI Actually Cause CKD?
Shih-Chi KuTaiwan Moderator
  • Lui ForniUnited Kingdom Speaker Sepsis Associated AKIBicarbonate in AKI: Use and MisuseAdapting CRRT for Patients with Electrolyte and ACID-Base Disorders
  • Claudio RoncoItaly Speaker Hemoadsorption in the ICUSpecial Lecture: 50 Years of CRRT: A Journey Through InnovationRole of Renal Functional Reserve on AKI Risk and RecoveryHow Do I Use Hemadsorption in My PracticeManaging the Heart Failure Patient With Worsening Renal Function (WRF)
  • Keith Wille Speaker Connectology with Hybrid Systems: ECMO, Apheresis, ECCO2RExtracorporeal life support technologies are increasingly used in critical care settings, with integrating extracorporeal membrane oxygenation (ECMO), apheresis, and extracorporeal carbon dioxide removal (ECCO₂R) to provide multi-organ support. This session explores the principles, clinical applications, and challenges of extracorporeal systems and their integration into CRRT, focusing on the interaction between ECMO and renal replacement therapy (CRRT), the role of ECCO2R in respiratory failure, and the combination of apheresis for immunomodulation. Through discussion, participants will gain an understanding of patient selection, circuit configurations, anticoagulation strategies, and the physiological considerations that impact patient outcomes. Emphasis will be placed on optimizing patient management, recognizing complications, and developing a structured approach to hybrid extracorporeal therapy.AKI in Mechanical Circulatory SupportAcute kidney injury (AKI) is a frequent and important complication of cardiogenic shock and is strongly associated with adverse outcomes. Its pathogenesis is multifactorial, reflecting reduced cardiac output and renal perfusion, venous congestion, neurohormonal activation, systemic inflammation, vasopressor exposure, and hemodynamic instability. Mechanical circulatory support (MCS) may interrupt this cycle by restoring cardiac output, reducing venous congestion, and decreasing vasopressor requirements; however, MCS itself may contribute to kidney injury through hemolysis, embolic events, limb ischemia and rhabdomyolysis, bleeding, contrast exposure, and device-related hemodynamic disturbances. This presentation will review the mechanisms and clinical impact of AKI across commonly used temporary and durable MCS platforms, including intra-aortic balloon pumps, microaxial flow pumps, temporary ventricular assist devices, and durable LVADs. Particular emphasis will be placed on identifying potentially reversible contributors to AKI, understanding the relationship between timing of circulatory support and renal recovery, and managing patients who require concurrent kidney replacement therapy. Practical considerations for CRRT, including vascular access, anticoagulation, ultrafiltration, and interactions between CRRT and MCS, will also be discussed. How do I care for the Patient with ARDS and AKIAcute respiratory distress syndrome (ARDS) and acute kidney injury (AKI) frequently coexist in critically ill patients and together are associated with substantial morbidity and mortality. Their management is closely intertwined: mechanical ventilation, positive end-expiratory pressure, hemodynamic support, and fluid administration may influence renal perfusion and venous congestion, while AKI and fluid accumulation can worsen pulmonary edema, impair gas exchange, and complicate ventilator management. This presentation will provide a practical approach to the patient with concurrent ARDS and AKI, integrating pulmonary and kidney-focused strategies. Key topics will include lung-protective ventilation and its renal consequences, assessment and management of volume status, the role of conservative fluid strategies and de-resuscitation, and the use of diuretics and kidney replacement therapy to achieve fluid-balance goals. Attention will be given to when and how continuous renal replacement therapy can support fluid management in patients with severe respiratory failure, including those with hemodynamic instability. The session will emphasize coordinated decision-making between critical care and nephrology teams to balance lung protection, kidney perfusion, and overall organ support.
  • Jay KoynerUnited States Speaker Special lecture: 2026 KDIGO AKI Guideline UpdateI will be updating the audience on the major conceptual updates of the 2026 KDIGO AKI Guidelines. I will focus on Chapter 1 and 2, including the evolving definition of AKI/AKD, AKI trajectories, biomarkers, and risk prediction, together with selected key updates from Chapter 4 on nephrotoxin-associated kidney injuryTargeting Persistent AKI and Promoting RecoveryI have been working with my co-moderators to develop a case based presentation looking at the use of biomarkers to predict outcomes in a patient with dialysis requiring AKI. and we will be discussing the intracicies of providing AKI-care to those receiving dialysis and how best to wean patients from dialysis and the long term outpatient managment of these patients
Room 101

20th September 2026 Sunday

Time Session
08:30
10:15
Nattachai SrisawatThailand Moderator Precision Sepsis-AKI — Biomarkers, AI and Phenotyping in the Asia-PacificSepsis-associated AKI in the Asia-Pacific carries a burden that global datasets underrepresent. In the SEA-AKI prospective multicentre ICU study, AKI was very common, with stage 3 reaching 28.9%, and infectious disease among the independent risk factors for AKI development. In the InSEA-RRT registry — 2,315 critically ill patients with stage 3 AKI across 24 hospitals in Southeast Asia and India — 47% died during hospitalization, with major adverse kidney events tracked to two years. These cohorts expose the limits of treating sepsis-AKI as one disease. This lecture examines how damage and stress biomarkers, machine-learning models trained on regional rather than imported data, and sub-phenotyping by trajectory and host response can move us from a single creatinine-based label toward actionable patient groups. Emphasis will be on what is deployable in resource-variable settings, where biomarker access is uneven and registry infrastructure is often the practical starting point for precision medicine.Timing of DialysisWhen to start kidney replacement therapy (KRT) in AKI remains one of the most frequent bedside decisions in critical care, and the trial evidence has settled less than it first appears. ELAIN favoured early initiation, AKIKI and IDEAL-ICU did not, STARRT-AKI showed no survival benefit from an accelerated strategy with more dialysis dependence at 90 days, and AKIKI-2 found that delaying further offered no advantage and may cause harm. This session works through illustrative cases rather than trial summaries: the patient with rising creatinine but no urgent indication, refractory hyperkalaemia or acidosis demanding immediate treatment, the fluid-overloaded patient with worsening oxygenation, and the diuretic-responsive patient in whom watchful waiting proves correct. Each case is used to separate absolute indications from the discretionary zone where trials apply. Emphasis will be on practical decision aids — urine output trajectory, furosemide stress testing, fluid balance, and organ-support burden — and on when not starting is the better decision.Acute PD vs Acute HD: Which Is the Right Choice?For AKI requiring kidney replacement therapy outside well-resourced ICUs, the practical question is which modality can be started safely tonight. Acute peritoneal dialysis (PD) needs no vascular access, anticoagulation, water treatment, or machine, but concerns persist about clearance and ultrafiltration control. Our multicentre randomized trial assigned 157 patients with AKI to lower-dosage acute PD (18–24 L/day) or intermittent hemodialysis three times weekly. Sepsis caused 68% of AKI. Twenty-eight-day mortality was 50% versus 49% (risk difference 0.6%), meeting the prespecified noninferiority margin, with comparable dialysis-free survival and seven-day fluid balance. Complications diverged rather than favoured one modality: intradialytic hypotension was more frequent with hemodialysis, hypokalemia with PD. This lecture translates these findings into practice — where lower-dosage PD is a legitimate first choice, where it is not, how to prescribe and monitor it, and how modality availability shapes AKI preparedness in resource-limited settings.
  • Kianoush KashaniUnited States Speaker Practical Steps to Train (and Become) an AI-Era PhysicianAI in Critical Care Nephrology — State of the Art and the Path from Algorithm to BedsideCritical Care Nephrology: Literature ReviewChat GPT Applications in Critical Care Nephrology
  • Sejoong KimSouth Korea Speaker Korean Big-Data Experience in AKI and CRRT OutcomesSouth Korea has established a robust nationwide health data infrastructure, enabling large-scale analyses of acute kidney injury (AKI) and continuous renal replacement therapy (CRRT). Leveraging the Health Insurance Review and Assessment Service (HIRA) and National Health Insurance Service (NHIS) databases, Korean researchers have characterized AKI incidence, risk factors, and short- and long-term outcomes across diverse clinical settings. Studies utilizing CRRT data have identified predictors of mortality, renal recovery, and progression to chronic kidney disease. These big-data approaches provide critical real-world evidence, informing clinical practice and guiding future interventional strategies in critically ill patients with AKI.Precision Volume Management in CRRT: Insights from Bioimpedance and BiomarkersOptimal fluid balance is critical in critically ill patients undergoing continuous renal replacement therapy (CRRT), yet accurate volume assessment remains challenging. Bioimpedance analysis (BIA) offers a non-invasive, objective method to quantify fluid overload and guide individualized ultrafiltration targets. Complementing BIA, emerging biomarkers provide dynamic, real-time insights into volume status and end-organ perfusion. Integrating these tools into a precision medicine framework may optimize fluid removal strategies, reduce complications, and improve survival outcomes in CRRT-dependent patients. Prospective validation of this combined approach is warranted.
  • John ProwleUnited Kingdom Speaker Trajectories of Critical Illness – Defining Endotypes from Routine DataCritical illness is a heterogeneous syndrome characterized by diverse clinical trajectories and variable responses to treatment. Defining biologically and clinically meaningful endotypes using routinely collected healthcare data offers an opportunity to improve risk stratification, prognostication, and personalized therapeutic strategies, enabling earlier intervention, enhanced clinical decision-making, and precision medicine in critical care. In particular the transition from acute to persistent critical illness represents a pivotal phase in intensive care, marked by a shift from the initial disease insult to prolonged organ dysfunction driven by complex host responses. Early identification of patients at risk of this transition remains a major clinical challenge and opportunity.Dynamic Prescription of CRRT Ready for Prime TimeContinuous renal replacement therapy (CRRT) has evolved from a standardized supportive therapy to a platform for precision critical care. Increasing evidence suggests that fixed prescriptions fail to accommodate the dynamic physiological changes encountered during critical illness, resulting in suboptimal solute clearance, fluid management, and metabolic control. Dynamic prescription integrates evolving haemodynamic status, fluid balance, acid–base homeostasis, electrolyte disturbances, and recovery trajectories to optimize therapy delivery while minimizing complications and treatment interruptions. This paradigm supports individualized kidney support rather than protocol-driven care. Emerging decision-support systems and data-driven algorithms have the potential to transform CRRT into a responsive, patient-centred intervention, improving kidney recovery, organ support, and outcomes in critically ill patients. Adapting CRRT for patients with Electrolyte and acid-base disordersContinuous renal replacement therapy (CRRT) is uniquely positioned to provide precise correction of complex electrolyte and acid–base disturbances in critically ill patients. Beyond kidney support, modern CRRT prescriptions can be individualized to account for the severity and evolution of dysnatremia, dyskalemia, calcium disorders, and metabolic acidosis or alkalosis. Customization of dialysate and replacement fluid composition, treatment dose, buffer delivery, and regional citrate anticoagulation enables controlled correction while minimizing the risks of metabolic complications. Dynamic prescription based on serial biochemical monitoring and changing clinical physiology can be embedded into treatment protocols, facilitating safe correction of sodium, potassium, calcium, and bicarbonate abnormalities while optimizing organ support and improving outcomes in critically ill patients. Extracorporeal Therapies in Trauma, Burns and Cerebral OedemaExtracorporeal therapies (ECTs) are an important adjunct in the management of critically ill patients with severe trauma, major burns, and brain injuries. Acute kidney injury, systemic inflammation, rhabdomyolysis, and profound fluid and electrolyte disturbances frequently complicate these conditions, necessitating timely organ support. Continuous kidney replacement therapy (CKRT) provides effective management of metabolic derangements while enabling precise fluid balance in hemodynamically unstable patients. In trauma and burns, ECTs may facilitate the clearance of myoglobin in severe rhabdomyolysis, support fluid management during resuscitation, and could enable removal of damage or pathogen associated molecular patterns mediating multiorgan failure. In patients with cerebral edema, CKRT offers gradual osmotic control and minimizes intracranial pressure fluctuations compared with intermittent dialysis, making it the preferred modality when kidney replacement therapy is required. We will review current evidence, practical considerations, and emerging extracorporeal strategies, highlighting their role in improving physiological stability and supporting recovery in critically ill patients.
  • Lui ForniUnited Kingdom Speaker Sepsis Associated AKIBicarbonate in AKI: Use and MisuseAdapting CRRT for Patients with Electrolyte and ACID-Base Disorders
  • Kathleen LiuUnited States Speaker How do I Manage Patients with Combined Kidney and Liver FailureKidney-Ventilator Interactions and Kidney Protective Ventilation /or Lung and Kidney CrosstalkHow Do I Care for the Patient with ARDS and AKIDe-escalating and Transitioning RRT: Best Practices
Room 101AB
14:00
15:30
Adapting CRRT for Patients with Electrolyte and ACID-Base Disorders
  • John ProwleUnited Kingdom Speaker Trajectories of Critical Illness – Defining Endotypes from Routine DataCritical illness is a heterogeneous syndrome characterized by diverse clinical trajectories and variable responses to treatment. Defining biologically and clinically meaningful endotypes using routinely collected healthcare data offers an opportunity to improve risk stratification, prognostication, and personalized therapeutic strategies, enabling earlier intervention, enhanced clinical decision-making, and precision medicine in critical care. In particular the transition from acute to persistent critical illness represents a pivotal phase in intensive care, marked by a shift from the initial disease insult to prolonged organ dysfunction driven by complex host responses. Early identification of patients at risk of this transition remains a major clinical challenge and opportunity.Dynamic Prescription of CRRT Ready for Prime TimeContinuous renal replacement therapy (CRRT) has evolved from a standardized supportive therapy to a platform for precision critical care. Increasing evidence suggests that fixed prescriptions fail to accommodate the dynamic physiological changes encountered during critical illness, resulting in suboptimal solute clearance, fluid management, and metabolic control. Dynamic prescription integrates evolving haemodynamic status, fluid balance, acid–base homeostasis, electrolyte disturbances, and recovery trajectories to optimize therapy delivery while minimizing complications and treatment interruptions. This paradigm supports individualized kidney support rather than protocol-driven care. Emerging decision-support systems and data-driven algorithms have the potential to transform CRRT into a responsive, patient-centred intervention, improving kidney recovery, organ support, and outcomes in critically ill patients. Adapting CRRT for patients with Electrolyte and acid-base disordersContinuous renal replacement therapy (CRRT) is uniquely positioned to provide precise correction of complex electrolyte and acid–base disturbances in critically ill patients. Beyond kidney support, modern CRRT prescriptions can be individualized to account for the severity and evolution of dysnatremia, dyskalemia, calcium disorders, and metabolic acidosis or alkalosis. Customization of dialysate and replacement fluid composition, treatment dose, buffer delivery, and regional citrate anticoagulation enables controlled correction while minimizing the risks of metabolic complications. Dynamic prescription based on serial biochemical monitoring and changing clinical physiology can be embedded into treatment protocols, facilitating safe correction of sodium, potassium, calcium, and bicarbonate abnormalities while optimizing organ support and improving outcomes in critically ill patients. Extracorporeal Therapies in Trauma, Burns and Cerebral OedemaExtracorporeal therapies (ECTs) are an important adjunct in the management of critically ill patients with severe trauma, major burns, and brain injuries. Acute kidney injury, systemic inflammation, rhabdomyolysis, and profound fluid and electrolyte disturbances frequently complicate these conditions, necessitating timely organ support. Continuous kidney replacement therapy (CKRT) provides effective management of metabolic derangements while enabling precise fluid balance in hemodynamically unstable patients. In trauma and burns, ECTs may facilitate the clearance of myoglobin in severe rhabdomyolysis, support fluid management during resuscitation, and could enable removal of damage or pathogen associated molecular patterns mediating multiorgan failure. In patients with cerebral edema, CKRT offers gradual osmotic control and minimizes intracranial pressure fluctuations compared with intermittent dialysis, making it the preferred modality when kidney replacement therapy is required. We will review current evidence, practical considerations, and emerging extracorporeal strategies, highlighting their role in improving physiological stability and supporting recovery in critically ill patients.
    Lui ForniUnited Kingdom Speaker Sepsis Associated AKIBicarbonate in AKI: Use and MisuseAdapting CRRT for Patients with Electrolyte and ACID-Base Disorders
Room 101D