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15:30
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(Pre-Congress Workshop)
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Ashita Tolwani
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.Severe hypernatremia and hyperkalemia in AKI requiring KRT
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Ashita Tolwani
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.Severe hypernatremia and hyperkalemia in AKI requiring KRT
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Ashita Tolwani
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.Severe hypernatremia and hyperkalemia in AKI requiring KRT
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Nuttha Lumlertgul
Speaker
Solution and Fluid BalanceUtility of Lung Ultrasound, VEXUS and Bioimpedance Analysis in Volume Assessment During RRT Personalized Fluid Management with CRRT
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Ashita Tolwani
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.Severe hypernatremia and hyperkalemia in AKI requiring KRT
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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.
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Claudio Ronco
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)
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Ashita Tolwani
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.Severe hypernatremia and hyperkalemia in AKI requiring KRT
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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 Forni
Speaker
Sepsis Associated AKIBicarbonate therapy for AKI or Bicarbonate in AKI: Use and MisuseAdapting CRRT for Patients with Electrolyte and Acid-Base Disorders
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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.
Nuttha Lumlertgul
Speaker
Solution and Fluid BalanceUtility of Lung Ultrasound, VEXUS and Bioimpedance Analysis in Volume Assessment During RRT Personalized Fluid Management with CRRT
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(Pre-Congress Workshop)
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Yu-Wei Chen
Speaker
Initiating Acute PD in the ICU: What Actually Works in PracticeInitiating acute peritoneal dialysis in the ICU: what actually works in practice
Abstract:
While continuous renal replacement therapy (CRRT) and intermittent hemodialysis (IHD) remain the traditional defaults for managing acute kidney injury (AKI) in the intensive care unit (ICU), acute peritoneal dialysis (PD) has re-emerged as a highly effective, hemodynamically well-tolerated, and resource-efficient alternative. However, its widespread adoption is frequently hindered by logistical misconceptions, institutional inertia, and a lack of standardized bedside protocols.
This session, "Initiating acute peritoneal dialysis in the ICU: what actually works in practice," bridges the gap between theoretical guidelines and bedside reality. Designed for nephrologists and intensivists, the presentation will critically evaluate optimal patient selection criteria, highlighting which critically ill profiles—such as those with severe hemodynamic instability and heart failure—benefit most from acute PD. We will outline pragmatic prescription strategies, including tidal PD, automated cycling, and volume management, tailored to the fluctuating metabolic demands of the ICU patient.
Furthermore, the session will address troubleshooting common mechanical and infectious complications, such as dialysate leaks, inadequate clearance, and peritonitis, drawing on real-world evidence and multidisciplinary workflows. Ultimately, attendees will be equipped with actionable, evidence-based frameworks to confidently implement and manage acute PD, transforming it into a therapeutic tool in critical care nephrology.
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Hsuan-Jen Lin
Speaker
Case-Based Demonstration and DiscussionPrescription Design and Adjustment Exercises (Case-based discussion)Troubleshooting Common ICU Problems (Case-based discussion)
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Che-Yi Chou
Speaker
Acute PD: Physiology, Prescription, and Technique (Surgical vs Percutaneous Implantation)Acute peritoneal dialysis (PD) is an effective, underutilized method for treating acute kidney injury through optimized, high-volume automated regimens. While percutaneous bedside insertion offers rapid, resource-efficient access for critically ill patients, surgical techniques provide better visualization and lower early leak rates.Prescription Design and Adjustment Exercises (Case-based discussion)This interactive, case-based discussion session focuses on the practical application of peritoneal dialysis (PD) prescription design and dynamic troubleshooting. Clinical practitioners often face challenges when translating standard PD guidelines into individualized patient care, particularly when balancing solute clearance, ultrafiltration goals, and patient lifestyle preferences. Utilizing a series of real-world patient scenarios, this session guides participants through the step-by-step process of calculating initial automated PD (APD) and continuous ambulatory PD (CAPD) prescriptions based on residual renal function and peritoneal membrane transport characteristics. Participants will actively analyze clinical data from cases demonstrating inadequate clearance, fluid overload, and metabolic complications. Through hands-on exercises, attendees will learn to systematically adjust dwell times, exchange volumes, and dextrose concentrations to optimize therapy. By the conclusion of this session, participants will possess the critical thinking skills necessary to confidently manipulate PD prescription variables, manage common prescription failures, and improve long-term patient outcomes.Troubleshooting Common ICU Problems (Case-based discussion) This interactive, case-based discussion session addresses the rapid identification and management of critical mechanical, metabolic, and infectious complications in the intensive care unit. Using realistic patient scenarios, clinicians will practice troubleshooting ventilator dyssynchrony, hemodynamic instability, continuous renal replacement therapy (CRRT) circuit alarms, and acute metabolic crises. Through hands-on exercises, participants will interpret real-time clinical data, isolate root causes, and execute immediate corrective interventions. This session equips multidisciplinary ICU teams with the critical thinking skills, diagnostic algorithms, and collaborative strategies necessary to resolve technical failures promptly and improve patient outcomes in high-stress environments.
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Yu-Cyuan Hong
Speaker
Complication Management in Acute PD (UF Failure, Acidosis, Lytes, Peritonitis)Acute peritoneal dialysis remains a practical option for AKI when hemodynamic instability, coagulopathy, absent vascular access, or resource constraints limit extracorporeal therapy. Its complication profile, however, differs from that of chronic PD: the catheter is freshly placed, the membrane is acutely inflamed and often high-transport, exchanges are rapid and hypertonic.
First, inadequate ultrafiltration is separated into mechanical causes (catheter malposition, omental wrap, leak to pleural or subcutaneous tracking) and membrane-prescription causes. Management follows from that division — imaging and repositioning, or shortened dwell and adjusted tonicity — rather than reflexive escalation of dextrose concentration.
Electrolyte complications follow directly from the prescription: hypokalemia from potassium-free dialysate compounded by glucose-driven intracellular shift; hypernatremia from sodium sieving during short hypertonic dwells;
Peritonitis in acute PD differs from its chronic counterpart. Risk is front-loaded by bedside insertion, immediate use, and repeated manual exchanges, so prevention rests on closed connectology, cycling, and minimal manipulation. Short dwells dilute the effluent cell count, making neutrophil percentage more reliable than the absolute number; in a sedated septic patient the first sign may be falling ultrafiltration.
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Chia-Lin Wu
Speaker
Integration of Acute PD into AKI ProgramsAcute kidney injury (AKI) affects 30–60% of critically ill patients, and dialysis-requiring AKI carries substantial short-term mortality and long-term risk of chronic kidney disease. While continuous renal replacement therapy and intermittent hemodialysis remain the default modalities in most high-income ICUs, acute peritoneal dialysis (PD) has re-emerged as a guideline-supported, outcome-comparable alternative—particularly valuable when vascular access, anticoagulation, or extracorporeal capacity are limited. The 2020 ISPD guideline update has standardized safe prescribing, and the COVID-19 pandemic demonstrated that acute PD programs can be stood up rapidly under pressure, with outcomes consistent with standard care. This presentation argues that the principal barriers to integrating acute PD into AKI programs are not clinical but organizational. Drawing on international literature and regional case experience, it presents a practical framework for building a program: catheter access and prescription fundamentals; a genuine nephrology–intensivist–nursing collaborative model with defined roles and governance; structured training pathways for catheter insertion and bedside nursing delivery, including simulation-based approaches used in low-resource settings; logistics planning for supply chains, staffing, and cost; and strategies for overcoming institutional barriers such as credentialing, reimbursement, and clinician culture.
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Che-Yi Chou
Speaker
Acute PD: Physiology, Prescription, and Technique (Surgical vs Percutaneous Implantation)Acute peritoneal dialysis (PD) is an effective, underutilized method for treating acute kidney injury through optimized, high-volume automated regimens. While percutaneous bedside insertion offers rapid, resource-efficient access for critically ill patients, surgical techniques provide better visualization and lower early leak rates.Prescription Design and Adjustment Exercises (Case-based discussion)This interactive, case-based discussion session focuses on the practical application of peritoneal dialysis (PD) prescription design and dynamic troubleshooting. Clinical practitioners often face challenges when translating standard PD guidelines into individualized patient care, particularly when balancing solute clearance, ultrafiltration goals, and patient lifestyle preferences. Utilizing a series of real-world patient scenarios, this session guides participants through the step-by-step process of calculating initial automated PD (APD) and continuous ambulatory PD (CAPD) prescriptions based on residual renal function and peritoneal membrane transport characteristics. Participants will actively analyze clinical data from cases demonstrating inadequate clearance, fluid overload, and metabolic complications. Through hands-on exercises, attendees will learn to systematically adjust dwell times, exchange volumes, and dextrose concentrations to optimize therapy. By the conclusion of this session, participants will possess the critical thinking skills necessary to confidently manipulate PD prescription variables, manage common prescription failures, and improve long-term patient outcomes.Troubleshooting Common ICU Problems (Case-based discussion) This interactive, case-based discussion session addresses the rapid identification and management of critical mechanical, metabolic, and infectious complications in the intensive care unit. Using realistic patient scenarios, clinicians will practice troubleshooting ventilator dyssynchrony, hemodynamic instability, continuous renal replacement therapy (CRRT) circuit alarms, and acute metabolic crises. Through hands-on exercises, participants will interpret real-time clinical data, isolate root causes, and execute immediate corrective interventions. This session equips multidisciplinary ICU teams with the critical thinking skills, diagnostic algorithms, and collaborative strategies necessary to resolve technical failures promptly and improve patient outcomes in high-stress environments.
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Che-Yi Chou
Speaker
Acute PD: Physiology, Prescription, and Technique (Surgical vs Percutaneous Implantation)Acute peritoneal dialysis (PD) is an effective, underutilized method for treating acute kidney injury through optimized, high-volume automated regimens. While percutaneous bedside insertion offers rapid, resource-efficient access for critically ill patients, surgical techniques provide better visualization and lower early leak rates.Prescription Design and Adjustment Exercises (Case-based discussion)This interactive, case-based discussion session focuses on the practical application of peritoneal dialysis (PD) prescription design and dynamic troubleshooting. Clinical practitioners often face challenges when translating standard PD guidelines into individualized patient care, particularly when balancing solute clearance, ultrafiltration goals, and patient lifestyle preferences. Utilizing a series of real-world patient scenarios, this session guides participants through the step-by-step process of calculating initial automated PD (APD) and continuous ambulatory PD (CAPD) prescriptions based on residual renal function and peritoneal membrane transport characteristics. Participants will actively analyze clinical data from cases demonstrating inadequate clearance, fluid overload, and metabolic complications. Through hands-on exercises, attendees will learn to systematically adjust dwell times, exchange volumes, and dextrose concentrations to optimize therapy. By the conclusion of this session, participants will possess the critical thinking skills necessary to confidently manipulate PD prescription variables, manage common prescription failures, and improve long-term patient outcomes.Troubleshooting Common ICU Problems (Case-based discussion) This interactive, case-based discussion session addresses the rapid identification and management of critical mechanical, metabolic, and infectious complications in the intensive care unit. Using realistic patient scenarios, clinicians will practice troubleshooting ventilator dyssynchrony, hemodynamic instability, continuous renal replacement therapy (CRRT) circuit alarms, and acute metabolic crises. Through hands-on exercises, participants will interpret real-time clinical data, isolate root causes, and execute immediate corrective interventions. This session equips multidisciplinary ICU teams with the critical thinking skills, diagnostic algorithms, and collaborative strategies necessary to resolve technical failures promptly and improve patient outcomes in high-stress environments.
Hsuan-Jen Lin
Speaker
Case-Based Demonstration and DiscussionPrescription Design and Adjustment Exercises (Case-based discussion)Troubleshooting Common ICU Problems (Case-based discussion)
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Che-Yi Chou
Speaker
Acute PD: Physiology, Prescription, and Technique (Surgical vs Percutaneous Implantation)Acute peritoneal dialysis (PD) is an effective, underutilized method for treating acute kidney injury through optimized, high-volume automated regimens. While percutaneous bedside insertion offers rapid, resource-efficient access for critically ill patients, surgical techniques provide better visualization and lower early leak rates.Prescription Design and Adjustment Exercises (Case-based discussion)This interactive, case-based discussion session focuses on the practical application of peritoneal dialysis (PD) prescription design and dynamic troubleshooting. Clinical practitioners often face challenges when translating standard PD guidelines into individualized patient care, particularly when balancing solute clearance, ultrafiltration goals, and patient lifestyle preferences. Utilizing a series of real-world patient scenarios, this session guides participants through the step-by-step process of calculating initial automated PD (APD) and continuous ambulatory PD (CAPD) prescriptions based on residual renal function and peritoneal membrane transport characteristics. Participants will actively analyze clinical data from cases demonstrating inadequate clearance, fluid overload, and metabolic complications. Through hands-on exercises, attendees will learn to systematically adjust dwell times, exchange volumes, and dextrose concentrations to optimize therapy. By the conclusion of this session, participants will possess the critical thinking skills necessary to confidently manipulate PD prescription variables, manage common prescription failures, and improve long-term patient outcomes.Troubleshooting Common ICU Problems (Case-based discussion) This interactive, case-based discussion session addresses the rapid identification and management of critical mechanical, metabolic, and infectious complications in the intensive care unit. Using realistic patient scenarios, clinicians will practice troubleshooting ventilator dyssynchrony, hemodynamic instability, continuous renal replacement therapy (CRRT) circuit alarms, and acute metabolic crises. Through hands-on exercises, participants will interpret real-time clinical data, isolate root causes, and execute immediate corrective interventions. This session equips multidisciplinary ICU teams with the critical thinking skills, diagnostic algorithms, and collaborative strategies necessary to resolve technical failures promptly and improve patient outcomes in high-stress environments.
Hsuan-Jen Lin
Speaker
Case-Based Demonstration and DiscussionPrescription Design and Adjustment Exercises (Case-based discussion)Troubleshooting Common ICU Problems (Case-based discussion)
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Hsiu-Chien Yang
Speaker
Hands-on PD Catheter InsertionPeritoneal dialysis is a treatment option for end-stage renal disease. Percutaneous peritoneal dialysis catheter implantation is a valuable skill that nephrologists should acquire. Through this workshop and subsequent self-training assessments, nephrologists can gradually develop proficiency in this procedure, enabling more suitable patients to receive timely and appropriate peritoneal dialysis treatment.
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Detective Mode On ! Decoding Alarms and Restoring the Truth - Common Alarm Management and Medical Orders
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Stronger Together: Advancing CRRT + ECMO Integrated Care
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Precision Adsorption, Purifying the Critically ill : Comprehensive Guide to Adsorptive Therapy
Hai-Hsi Chen
Speaker
CytoSorb療法臨床應用本教學主要說明 CytoSorb 血液吸附治療於臨床常見之適應症——敗血症、急性肝衰竭與橫紋肌溶解症—中的角色，重點在於藉由吸附過量發炎介質與中分子毒素，協助降低全身性發炎反應與器官負荷；同時說明其與CRRT 及 ECMO 串聯應用之實務原則，包括建議放置位置、血流方向與基本操作流程，協助臨床團隊在重症病人血液淨化與體外循環治療中，安全且有效地整合 CytoSorb 於既有治療架構中。
Yu-Ning Chen
Speaker
精準吸附，淨化重症：吸附罐串接實戰全攻略本教學主要說明 CytoSorb 血液吸附治療於臨床常見之適應症——敗血症、急性肝衰竭與橫紋肌溶解症—中的角色，重點在於藉由吸附過量發炎介質與中分子毒素，協助降低全身性發炎反應與器官負荷；同時說明其與CRRT 及 ECMO 串聯應用之實務原則，包括建議放置位置、血流方向與基本操作流程，協助臨床團隊在重症病人血液淨化與體外循環治療中，安全且有效地整合 CytoSorb 於既有治療架構中。
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Critical Decisions in Your Hands: Simulation-Based CRRT Workshop -Case Discussion & Parameter Adjustment
Shu-Ping Liu
Speaker
關鍵決策，由你掌控:模擬CRRT療程中的實戰課提供模擬病人生理監測紀錄，學員以團體合作根據多變的生命徵象（如血壓下降、TMP過高）動態調整治療參數，訓練臨床應變力與醫護共同決策能力。
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17:50
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Precision Pharmacotherapy for Acute Hyperkalemia
Yu-Chang YEH
Moderator
Clinical Support Information with Generative AI: Content Generation and Evaluation Generative artificial intelligence is shifting from single-question answering toward structured clinical decision support at the bedside. This lecture presents a practical approach to generating and evaluating AI-derived clinical support information in critical care. On the generation side, we describe a multi-turn conversation and multi-task workflow in which structured patient data, a machine learning mortality prediction model, and SHAP-based explanations are passed sequentially to a large language model through five linked task prompts covering risk interpretation, syndrome identification, current status and diagnoses, recommended examinations, and management suggestions. Each turn inherits the context of the previous one, so the output accumulates into a coherent clinical narrative rather than a set of isolated answers. On the evaluation side, we introduce the IMPACT Framework, a six-domain, 21-item instrument developed through a multinational Delphi consensus involving 58 panelists from 12 countries. Its domains, Integration, Mastery, Precision, Applicability, Comprehensiveness, and Timeliness, allow both clinicians and automated judges to score generated content reproducibly. We share validation results, examples from an intensive care cohort, and lessons learned from iterative prompt refinement. Attendees will leave with a transferable method for building and auditing generative AI support tools in their own units.
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From Potassium Removal to Rebound Prevention and Discharge Bridging
Yen-Ta Huang
Moderator
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
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Impact of Acute Hyperkalemia on CKM Therapy: Restoring Guideline-directed Treatment and Future Perspectives
VinCent Wu
Speaker
AKD Care Redefined: Diabetes, Hypertension, and Strategies for Long-Term Health Traditional acute kidney injury (AKI) classifications, centered around semi-anatomical lines, no longer suffice in capturing the complexity of AKI. Subphenotyping, enriched with AKI biomarkers, holds insights into distinct risk profiles and tailored treatment strategies, redefining AKI and contributing to improved clinical management (Critical Care). Incorporating kidney biomarkers into strategies for early AKI detection and the initiation of AKI care bundles has shown greater effectiveness than using care bundles without these novel biomarkers. Our investigations have made notable advancements in identifying water-soluble regulatory iron hepcidin as a promising early biomarker for predicting postoperative acute kidney injury. Beyond hepcidin, our research extended into the exploration of predictive biomarkers, such as HJV, NGAL, and cFGF-23, uncovering their potential in prognosticating the occurrence and severity of AKI (Cell Death Dis, Antioxidants & redox signaling). The amalgamation of these biomarkers with existing clinical AKI scores holds immense promise in revolutionizing critical care and ushering in a new era of personalized patient management. Moreover, our endeavors have transcended theoretical advancements, with successful patent acquisition for AKI biomarkers attesting to our commitment. We were the inaugural contributors to the discourse on the effects of indoxyl sulfate on the tubulogenesis capability of endothelial progenitor cells and cell aging in acute kidney injury(Angiogenesis). A comprehensive review of the long-term prognosis of acute kidney injury, encompassing impacts on the heart, brain, bone lesions, gastrointestinal, and tissue carcinogenesis, was presented. (JASN, KI, cJASN, JAHA, ICM, CC). Our team posited that transferring post-AKI patients to nephrologists for care could reduce overall mortality and cardiovascular events (Value in Health). Through integrated analysis, we demonstrated that standard dialysis would increase the number of patients avoiding dialysis (CC), stimulating fervent discussions among AKI physicians at international conferences. Notably, we were global trailblazers in proposing that acute kidney disease, regardless of AKI presence, leads to mortality and end-stage kidney disease(eClinicalMedicine ).
Although the evidence for patients with acute kidney disease (AKD) is still lacking, several potential pharmacological agents may improve outcomes, including but not limited to angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, mineralocorticoid receptor antagonists, sodium-glucose cotransporter 2 inhibitors, and glucagon-like peptide 1 receptor agonists (JAMA NO). In conclusion, accurate prognosis prediction and effective treatment for AKD are critical yet unmet clinical needs. Future studies are urgently needed to improve patient care in this complex and rapidly evolving field.
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(Vantive)
Ashita Tolwani
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.Severe hypernatremia and hyperkalemia in AKI requiring KRT
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Lui Forni
Speaker
Sepsis Associated AKIBicarbonate therapy for AKI or Bicarbonate in AKI: Use and MisuseAdapting CRRT for Patients with Electrolyte and Acid-Base Disorders
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18:00
19:00
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Epidemiology and Outcomes of AKI
#AKICRRT26-46
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Epidemiology and Outcomes of AKI
#AKICRRT26-35
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Research in AKI (basic, translational, clinical, trials)
#AKICRRT26-15
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Epidemiology and Outcomes of AKI
#AKICRRT26-62
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Epidemiology and Outcomes of AKI
#AKICRRT26-74
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Epidemiology and Outcomes of AKI
#AKICRRT26-57
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Multidisciplinary
#AKICRRT26-49
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RRT Applications and Targeted Interventions
#AKICRRT26-180
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Rolando Claure-Del Granado
Moderator
Practical Steps to Train (and Become) an AI-Era PhysicianArtificial intelligence is rapidly becoming part of everyday medicine, yet many physicians remain uncertain about how to begin using it effectively and responsibly. Becoming an “AI-era physician” does not require advanced technical expertise; it requires curiosity, critical thinking, and practical skills that can be progressively incorporated into clinical, academic, and research activities. In this Meet the Experts session, participants will explore concrete approaches to developing AI literacy, improving prompting skills, critically evaluating AI-generated information, and identifying useful applications in clinical reasoning, education, scientific writing, research, and workflow optimization. Through expert perspectives, real-world examples, and interactive discussion, the session will also address common pitfalls, including hallucinations, bias, privacy concerns, and overreliance on automation. The goal is to provide participants with a practical roadmap for moving from occasional AI use to confident, thoughtful, and responsible integration of AI into professional practice.Precision Solute Control and Dynamic Dosing with CRRTContinuous kidney replacement therapy (CRRT) is often prescribed using fixed effluent targets, yet critically ill patients have rapidly changing metabolic demands, solute loads, and treatment goals. Precision CRRT requires moving beyond a “one-dose-fits-all” approach toward dynamic prescription and real-time adjustment of therapy. In this interactive workshop, participants will learn how to individualize CRRT dose according to clinical objectives, solute kinetics, treatment interruptions, residual kidney function, and evolving metabolic needs. Practical case-based exercises will address clearance of urea and other small solutes, management of severe hyperkalemia and metabolic acidosis, control of sodium and other electrolyte disorders, and strategies for avoiding under- or overdosing. The workshop will also explore how modality, blood flow, dialysate and replacement-fluid rates, predilution, and delivered versus prescribed dose influence solute clearance. Participants will leave with a practical framework for adapting CRRT prescriptions dynamically and safely at the bedside.Social Determinants of Health and Acute Kidney InjuryAcute kidney injury (AKI) is not only a clinical syndrome but also a reflection of social and structural inequities that shape who becomes ill, who receives timely diagnosis, and who survives. Poverty, geography, education, access to clean water and sanitation, healthcare availability, occupational exposures, and delayed referral can all influence the risk, severity, and outcomes of AKI. These determinants are particularly relevant in low- and middle-income settings, where preventable causes of AKI remain common and access to laboratory testing, specialist care, and kidney replacement therapy may be limited. This plenary session will examine how social determinants interact with biological vulnerability and health-system capacity across the AKI continuum—from prevention and early recognition to treatment and recovery. Addressing AKI effectively therefore requires more than advances in diagnostics and therapeutics; it demands equitable health systems, stronger prevention strategies, and policies that reduce barriers to timely kidney care.
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RRT Applications and Targeted Interventions
#AKICRRT26-131
Sejoong Kim
Presenter
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.
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Research in AKI (basic, translational, clinical, trials)
#AKICRRT26-134
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Research in AKI (basic, translational, clinical, trials)
#AKICRRT26-210
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RRT Applications and Targeted Interventions
#AKICRRT26-9
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Multidisciplinary
#AKICRRT26-10
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RRT Applications and Targeted Interventions
#AKICRRT26-22
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Epidemiology and Outcomes of AKI
#AKICRRT26-20
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Acute RRT Techniques
#AKICRRT26-21
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Shotaro Matsumoto
Moderator
The Ultimate Support: Heart-Lung-Kidney Crosstalk and ECMO-CRRT Integration in PediatricsCore Decisions: Modality Selection (CVVH / CVVHD / CVVHDF) & Prescription
Yu-Wei Chen
Moderator
Initiating Acute PD in the ICU: What Actually Works in PracticeInitiating acute peritoneal dialysis in the ICU: what actually works in practice
Abstract:
While continuous renal replacement therapy (CRRT) and intermittent hemodialysis (IHD) remain the traditional defaults for managing acute kidney injury (AKI) in the intensive care unit (ICU), acute peritoneal dialysis (PD) has re-emerged as a highly effective, hemodynamically well-tolerated, and resource-efficient alternative. However, its widespread adoption is frequently hindered by logistical misconceptions, institutional inertia, and a lack of standardized bedside protocols.
This session, "Initiating acute peritoneal dialysis in the ICU: what actually works in practice," bridges the gap between theoretical guidelines and bedside reality. Designed for nephrologists and intensivists, the presentation will critically evaluate optimal patient selection criteria, highlighting which critically ill profiles—such as those with severe hemodynamic instability and heart failure—benefit most from acute PD. We will outline pragmatic prescription strategies, including tidal PD, automated cycling, and volume management, tailored to the fluctuating metabolic demands of the ICU patient.
Furthermore, the session will address troubleshooting common mechanical and infectious complications, such as dialysate leaks, inadequate clearance, and peritonitis, drawing on real-world evidence and multidisciplinary workflows. Ultimately, attendees will be equipped with actionable, evidence-based frameworks to confidently implement and manage acute PD, transforming it into a therapeutic tool in critical care nephrology.
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Blood Purification and Organ Support
#AKICRRT26-176
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Multidisciplinary
#AKICRRT26-206
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Epidemiology and Outcomes of AKI
#AKICRRT26-51
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Research in AKI (basic, translational, clinical, trials)
#AKICRRT26-133
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Nursing Issues
#AKICRRT26-169
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Blood Purification and Organ Support
#AKICRRT26-29
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RRT Applications and Targeted Interventions
#AKICRRT26-213
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