Regional Symposium (AKD/EBM)

19 Sep 2026 16:00 17:30

3F South Lounge

AKD in Asia-Pacific: Post-AKI Recovery, Critical Illness, and Regional Phenotypes

Tai-Shuan LaiTaiwan Moderator

WEIHUNG LinTaiwan Moderator 重症腎臟醫學的能力架構：里程碑與 EPAs 重症腎臟醫學的能力架構：里程碑與可信賴專業活動（EPAs）林威宏醫師醫學系副系主任｜教學中心主任｜內科部副部長｜一般內科主任成功大學醫學院附設醫院重症腎臟醫學要求臨床醫師在高度不確定、時間敏感且跨專業的情境中，整合急性腎損傷、腎替代治療、電解質與酸鹼異常、液體與血流動力學，以及倫理與溝通等多重能力。傳統以訓練年資、授課主題或病例數為主的課程，往往無法回答最關鍵的問題：受訓醫師究竟能在何種督導程度下，安全且一致地完成真實臨床任務？本演講將介紹一套適用於重症醫學專科訓練的「重症腎臟醫學核心能力框架」草案。此框架以能力導向醫學教育為基礎，將 ACGME 六大核心能力整合至六個臨床領域，建構18項可信賴專業活動（entrustable professional activities, EPAs）及五階段里程碑。L4定義為完訓時可被信賴執行的目標層級；在臺灣ICU主治醫師覆核文化下，對應於間接督導及次日覆核，L5則代表完訓後的進階專家發展。七項涉及病人安全的核心任務被列為must-pass EPAs，包括腎臟替代療法的適應症與時機、CRRT處方、CRRT劑量調整與治療藥物監測、危急電解質異常、以床邊超音波及VExUS評估液體反應性與靜脈充血、敗血症相關AKI，以及腎臟替代療法撤除與緩和醫療。評量採多工具、縱向及多來源的整合式評量，結合病例討論、mini-CEX、DOPS、模擬式OSCE、360度回饋與學習歷程；罕見但高風險的臨床情境，可由模擬、病歷回顧或結構式病例討論補足。建議的完訓門檻為七項must-pass EPAs全數達L4、18項中至少15項達L4，其餘至少達L3，並完成跨團隊品質改善成果。此框架將訓練焦點由「教過多少、做過幾例」轉向「能否在適當督導下可靠完成臨床工作」，並透過可觀察表現、持續回饋與縱向進展，支持可辯護的信賴決策，同時為後續AI輔助學習與可信賴教育系統提供由臨床專業所界定的能力基礎。關鍵詞：能力導向醫學教育、重症腎臟醫學、可信賴專業活動、里程碑、整合式評量 Competency Frameworks in Critical Care Nephrology: Milestones and Entrustable Professional Activities (EPAs) Wei-Hung Lin, MD, PhD Vice Chair, Department of Medicine, College of Medicine, National Cheng Kung University Director, Education Center Deputy Director, Department of Internal Medicine Chief, Division of General Internal Medicine National Cheng Kung University Hospital (NCKUH), College of Medicine, National Cheng Kung University Critical care nephrology requires clinicians to integrate acute kidney injury, renal replacement therapy, electrolyte and acid–base disorders, fluid and hemodynamic management, and ethically complex communication in time-sensitive, uncertain, and interprofessional settings. Traditional curricula based on training duration, covered topics, or case numbers do not adequately answer a fundamental question: What clinical work can a trainee be trusted to perform, and at what level of supervision? This lecture introduces a proposed competency-based framework for postgraduate training in critical care nephrology. The framework maps the six Accreditation Council for Graduate Medical Education core competencies across six clinical domains and organizes authentic workplace practice into 18 entrustable professional activities (EPAs) with five developmental milestone levels. Level 4 (L4) represents the graduation target—interpreted in the Taiwanese ICU context as indirect supervision with next-day attending review—whereas L5 denotes aspirational post-training expertise. Seven safety-critical EPAs require achievement of L4: determining the indications and timing of renal replacement therapy; prescribing continuous renal replacement therapy (CRRT); adjusting CRRT dose and therapeutic drug monitoring; managing life-threatening electrolyte disorders; assessing fluid responsiveness and venous congestion using point-of-care ultrasound (POCUS) and venous excess ultrasound (VExUS); managing sepsis-associated AKI; and leading decisions on withdrawal of renal replacement therapy and palliative care. Assessment is programmatic, longitudinal, and multisource, combining case-based discussion, mini-CEX, direct observation of procedural skills, simulation-based OSCEs, multisource feedback, and a longitudinal portfolio. Simulation, chart review, and structured case conferences can address low-frequency, high-risk clinical exposures. Proposed graduation standards require all seven must-pass EPAs and at least 15 of 18 EPAs to reach L4, with the remainder at L3 or above, plus documented interprofessional quality-improvement work. By shifting the focus from content coverage and case counting to observable performance, feedback, progression, and defensible entrustment decisions, the framework provides a clinically defined foundation for subsequent AI-enabled learning and trustworthy education systems. Keywords: competency-based medical education; critical care nephrology; entrustable professional activities; milestones; programmatic assessment

What will be covered
Acute kidney injury(AKI) does not end when serum creatinine begins to improve. This regional forum examines the transition from AKI to acute kidney disease(AKD), focusing on post-AKI recovery, critical illness, fluid management, immune-mediated repair, and potentially preventable progression.

Experts from Taiwan, Malaysia, Korea, and the Philippines will share clinical, translational, and regional perspectives on how AKD phenotypes differ across Asia-Pacific healthcare settings and how recovery-oriented care pathways can be improved.

What participants will learn

How to recognize high-risk phenotypes during the transition from AKI to AKD.
How fluid management and critical illness influence kidney recovery.
How immune-mediated repair may contribute to recovery or progression after AKI.
How early recognition and risk reduction may prevent avoidable AKI and AKD progression.
How Asia-Pacific countries can develop more effective post-AKI follow-up and recovery pathways.

Take-home value
Participants will gain a regional and clinically relevant framework for identifying patients at risk of incomplete kidney recovery and for building better post-AKI surveillance, prevention, and recovery-oriented care pathways.

Format
Four invited lectures followed by an interactive panel discussion and audience Q&A.

Target audience
Intensivists, nephrologists, critical care fellows, ICU advanced-practice nurses, and clinical and translational researchers involved in AKI, AKD, and post-critical illness care.

Invited speakers

Chen Jia-Jin, Taiwan
From AKI to AKD: Recovery Pathways and High-Risk Phenotypes
Nurul Zaynah Nordin, Malaysia
Can the Kidney Truly Recover After AKI? Fluid Management, Critical Illness, and the AKD Continuum
Kyungho Lee, Korea
Immune-Mediated Repair After AKI: From Recovery to AKD Progression
Maria Erika Ramirez, Philippines
Preventable AKI and AKD: A Philippine Perspective on Early Recognition and Risk Reduction

Panel discussion
How should Asia-Pacific build better post-AKI and AKD recovery and prevention pathways?

Registration requirement
Included in congress registration. Seating is subject to room capacity.

亞太地區 AKD 論壇：AKI 後恢復、重症照護與區域性表現型
從恢復路徑、體液管理、免疫修復到可預防的疾病進展

談什麼
Acute kidney injury(AKI) 並不會在血清肌酸酐開始下降時就真正結束。本場亞太區域論壇聚焦 AKI 向急性腎臟病轉變的過程，討論 AKI 後腎臟恢復、重症與體液管理、免疫介入修復，以及可能可以預防的 AKD 進展。

來自臺灣、馬來西亞、韓國與菲律賓的專家，將從臨床、轉譯研究及區域醫療系統的角度，分享亞太不同地區的 AKD 高風險表型與恢復照護策略。

學什麼

辨識 AKI 進展為 AKD 過程中的高風險臨床表型。
理解重症病患的體液管理如何影響腎臟恢復。
探討免疫介入修復如何影響 AKI 後恢復或疾病進展。
了解早期辨識與風險降低如何減少可預防的 AKI 與 AKD。
思考亞太地區如何建立更有效的 AKI 後追蹤、預防與恢復照護策略。

得到什麼
帶回一套具有亞太區域觀點、且可應用於臨床的 AKI 後恢復照護架構，協助辨識腎功能未完全恢復的高風險病人，並改善後續追蹤、風險分層及預防策略。

場次形式
四場專題演講，接續專家 panel discussion 與現場問答。

適合對象
重症醫師、腎臟科醫師、重症醫學與腎臟科受訓醫師、加護病房進階照護人員，以及從事 AKI、AKD 與重症後照護的臨床及轉譯研究人員。

講者與主題

陳佳晉，臺灣
從 AKI 到 AKD：恢復路徑與高風險表型
Nurul Zaynah Nordin，馬來西亞
AKI 後腎臟真的能完全恢復嗎？體液管理、重症與 AKD 連續病程
Kyungho Lee，韓國
AKI 後免疫介入修復：從腎臟恢復到 AKD 進展
Maria Erika Ramirez，菲律賓
可預防的 AKI 與 AKD：菲律賓早期辨識與風險降低經驗

Panel discussion
亞太地區應如何建立更完善的 AKI／AKD 恢復與預防照護路徑？

報名
已包含於大會註冊費；座位依會場容量開放。

Time	Session

16:00	16:00 16:05 Chair's Opening: Framing Post-AKI Recovery, Critical Illness, and Regional AKD Phenotypes
16:05	16:05 16:20 Talk 1: From AKI to AKD: Recovery Pathways and High-Risk Phenotypes
16:20	16:20 16:35 Talk 2: Can the Kidney Truly Recover After AKI? Fluid Management, Critical Illness, and the AKD Continuum
16:35	16:35 16:50 Talk 3: Immune-Mediated Repair After AKI: From Recovery to AKD Progression
16:50	16:50 17:05 Talk 4: Preventable AKI and AKD: A Philippine Perspective on Early Recognition and Risk Reduction
17:05	17:05 17:25 Panel Discussion / Q&A: How Should Asia-Pacific Build Better Post-AKI/AKD Recovery and Prevention Pathways?
17:25	17:25 17:30 Chair's Synthesis and Take-Home Points

Regional Symposium (AKD/EBM)

Abstract List