| Time |
Session |
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07:30
08:00
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08:00
12:30
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(Pre-Congress Workshop)
Room 101AB
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(Pre-Congress Workshop)
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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。
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Yu-Wei ChenTaiwan
Speaker
Initiating Acute PD in the ICU: What Actually Works in Practice
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Hsuan-Jen LinTaiwan
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 ChouTaiwan
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 HongTaiwan
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 WuTaiwan
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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Room 101C
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(Pre-Congress Workshop)
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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
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Manish KaushikSingapore
Speaker
Patient Selection, Modality, DoseAccess, Membrane, CircuitSevere Hypernatremia and Hyperkalemia in AKI Requiring KRTPrecision Solute Control and Dynamic Dosing with CRRT
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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
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Manish KaushikSingapore
Speaker
Patient Selection, Modality, DoseAccess, Membrane, CircuitSevere Hypernatremia and Hyperkalemia in AKI Requiring KRTPrecision Solute Control and Dynamic Dosing with CRRT
-
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
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Nuttha LumlertgulThailand
Speaker
Solution and Fluid BalanceUtility of Lung Ultrasound, VEXUS and Bioimpedance Analysis in Volume Assessment During RRTPersonalized Fluid Management with CRRT
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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
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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 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)
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Room 101D
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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-Hsia ChenTaiwan
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 ChenTaiwan
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 LiuTaiwan
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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Room 103
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12:30
13:00
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|
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13:30
15:30
|
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Che-Yi ChouTaiwan
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 ChouTaiwan
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 LinTaiwan
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 ChouTaiwan
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 LinTaiwan
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 YangTaiwan
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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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。
Room 101AB
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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
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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 ForniUnited Kingdom
Speaker
Sepsis Associated AKIBicarbonate in AKI: Use and MisuseAdapting CRRT for Patients with Electrolyte and ACID-Base Disorders
Room 101C
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Zsolt MolnárHungary
Speaker
Managing Patients with Sepsis: modifying the course with ECOSA dysregulated host response to infection is central to the pathophysiology of sepsis and may culminate in life-threatening organ dysfunction. Given that this process is largely characterized by concurrent pro- and anti-inflammatory activation, immunomodulatory strategies have long been explored in sepsis research. Among these, extracorporeal removal of circulating cytokines, inflammatory mediators and other soluble factors through non-specific hemoadsorption with macroporous styrene-divinylbenzene sorbents has been proposed as a potential therapeutic approach. Its adoption into clinical practice has largely been based on pathophysiological considerations rather than on evidence from large, well-designed randomized clinical trials. Over the past 15 years, most of the available evidence has been predominantly derived from small, single-center cohorts, reports from registries and heterogeneous prospective studies with substantial variability in patients’ selection, timing, and treatment intensity. In addition, the precise mechanisms of action of hemoadsorption remain incompletely understood. Although several meta-analyses have attempted to synthesize the existing data, the overall quality and heterogeneity of the included studies limit the strength and reliability of their conclusions. As a result, current guideline recommendations are largely based on expert opinions rather than high-certainty evidence. This presentation aims to provide a concise overview of the biological rationale, current evidence, and contemporary clinical practice related to hemoadsorption in sepsis.Multimodal individualized hemodynamic managementAchieving hemodynamic stability in the critically ill patents has a pivotal role in ensuring positive outcomes. The pathomechanism is complex and include impaired
myocardial contractility, relative or absolute intravascular hypovolaemia, bradycardia, and thus eventually impaired blood flow. Arterial pressure can be monitored continuously, which makes it the most important and feasible tool to assess circulation in real time. A given level of the mean arterial pressure (MAP) is often regarded as the main target to be normalized in several guidelines. However, it is not the sole
determinant of organ perfusion pressure and, although coupled to blood flow, is not a surrogate of blood flow or tissue perfusion. Conversely, normotension does not guarantee adequate organ blood flow and may just mimic ‘occult hypoperfusion’. Therefore, achieving hemodynamic coherence between macro- and microcirculation should be our pivotal aim during resuscitation and hemodynamic management. This requires a complex approach that is called multimodal, individualised, contextualised management that takes into account all measurable components of oxygen delivery and consumption, organ perfusion and cardiac output. How to do it at the bedside, will be presented on this lecture.
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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 LumlertgulThailand
Speaker
Solution and Fluid BalanceUtility of Lung Ultrasound, VEXUS and Bioimpedance Analysis in Volume Assessment During RRTPersonalized Fluid Management with CRRT
Room 103
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14:00
17:30
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The First Hour in the Emergency Department: Critical Thresholds, ECG, and Early Treatment Decisions
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Why Taiwan Needs an Acute Hyperkalemia Guideline: Rationale, Methodology, and Epidemiology
Thomas Tao-Min HuangTaiwan
Speaker
Overview of Acute kidney injury and Continuous Renal Replacement Therapy in Critical Care本演講概述重症病人急性腎損傷與 CRRT 之臨床決策、適應症、處方原則與治療監測,強化從決策到執行的實務能力。Connecting CRRT to ECMO: Circuit Configuration, Anticoagulation, and Quality Metrics
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Hyperkalemic Cardiac Arrest and Peri-arrest: Prioritizing Calcium, Insulin–Glucose, and Bicarbonate
Thomas Tao-Min HuangTaiwan
Speaker
Overview of Acute kidney injury and Continuous Renal Replacement Therapy in Critical Care本演講概述重症病人急性腎損傷與 CRRT 之臨床決策、適應症、處方原則與治療監測,強化從決策到執行的實務能力。Connecting CRRT to ECMO: Circuit Configuration, Anticoagulation, and Quality Metrics
Room 101D
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15:30
16:00
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16:00
17:50
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(A then B)
Chi-yuan HsuUnited States
Moderator
Targeting Persistent AKI and Promoting RecoveryDoes Mild to Moderate AKI Actually Cause CKD?
Kathleen LiuUnited States
Moderator
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
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Kathleen LiuUnited States
Moderator
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
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Room 101C
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Precision Pharmacotherapy for Acute Hyperkalemia
Yu-Chang YEHTaiwan
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
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。
Yen-Ta HuangTaiwan
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 WuTaiwan
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.
Room 101D
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(C then D)
Mitra NadimUnited States
Moderator
Hepatorenal Syndrome: Recognition and Management or Disordered Physiology or Iatrogenic FailureManaging Patients With Combined Kidney and Liver FailureHow do I Manage Patients with Acute Liver Failure
Sejoong KimSouth Korea
Moderator
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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Sejoong KimSouth Korea
Moderator
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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Mitra NadimUnited States
Moderator
Hepatorenal Syndrome: Recognition and Management or Disordered Physiology or Iatrogenic FailureManaging Patients With Combined Kidney and Liver FailureHow do I Manage Patients with Acute Liver Failure
Room 103
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(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
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Lui ForniUnited Kingdom
Speaker
Sepsis Associated AKIBicarbonate in AKI: Use and MisuseAdapting CRRT for Patients with Electrolyte and ACID-Base Disorders
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Room 101AB
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17:10
18:00
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-
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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。
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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
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Lui ForniUnited Kingdom
Speaker
Sepsis Associated AKIBicarbonate in AKI: Use and MisuseAdapting CRRT for Patients with Electrolyte and ACID-Base Disorders
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「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
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Room 101AB
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18:00
19:00
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Kyungho LeeSouth Korea
Moderator
Drug Exposures: Concerns in Kidney Safety (PPI vs Potassiumcompetitive acid blockers (P-CABs))
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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
Room 101D
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Jia-Jin ChenTaiwan
Moderator
From AKI to AKD: Recovery Pathways and High-Risk PhenotypesAcute kidney disease (AKD) represents a critical transition between acute kidney injury (AKI) and chronic kidney disease. Drawing on real-world evidence from cardiac surgery, acute decompensated heart failure, and ECMO cohorts, this talk will illustrate how kidney recovery trajectories and AKD phenotypes identify patients at high risk for long-term kidney and cardiovascular events. It will also discuss opportunities to improve post-AKI care, including earlier resumption of RAAS inhibitors and emerging evidence for GLP-1 receptor agonists and SGLT2 inhibitors. Recognizing AKD may help transform post-AKI care from passive observation toward proactive cardiorenal risk management.
Rolando Claure-Del GranadoBolivia
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 KimSouth Korea
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
-
RRT Applications and Targeted Interventions
#AKICRRT26-9
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Multidisciplinary
#AKICRRT26-10
-
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
Room 101D
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Shotaro MatsumotoJapan
Moderator
The Ultimate Support: Heart-Lung-Kidney Crosstalk and ECMO-CRRT Integration in PediatricsExtracorporeal membrane oxygenation (ECMO) and continuous kidney replacement therapy (CKRT) support pediatric cardiopulmonary failure complicated by acute kidney injury (AKI) and fluid overload (FO). AKI and multiorgan dysfunction are increasingly viewed through bidirectional kidney-lung-heart crosstalk, extending in ECMO/CKRT patients to artificial organs: oxygenator, blood pump, and hemofilter.
Kidney-lung crosstalk shares pathways of vascular rigidity, neurohormonal activation, tissue hypoxia, and aberrant immune signaling. Ventilator-induced biotrauma impairs renal function, while AKI worsens lung injury via fluid, acid-base, and cytokine derangements; positive-pressure ventilation further raises right-ventricular afterload and central venous pressure, reducing renal perfusion. Kidney-heart crosstalk (cardiorenal syndrome type 3) involves analogous inflammatory and neuroendocrine mechanisms and carries a high mortality risk in children.
Beyond native organs, the oxygenator activates complement/inflammatory cascades via blood-biomaterial contact, and non-pulsatile pump flow causes shear-induced hemolysis, with free hemoglobin/iron contributing to AKI. CKRT-ECMO circuit connection requires attention to circuit pressures, embolism risk, and altered drug pharmacokinetics-challenges framed by the multiple organ support therapy (MOST) concept.
Key management priorities include early correction of FO, standardized CKRT-ECMO integration per PCRRT-ICONIC and ADQI/ELSO consensus recommendations, lung-protective ventilation and conservative fluid management, and long-term renal/blood-pressure surveillance after ECMO.
Research has evolved from single-center FO-mortality studies to consensus statements, the extracorporeal organ support concept, and the multicenter WE-ROCK registry, with recent work clarifying molecular mechanisms of sepsis-associated lung-kidney crosstalk. Future work should pursue biomarker-driven endotyping and integrated MOST platforms.Core Decisions: Modality Selection (CVVH / CVVHD / CVVHDF) & PrescriptionModality selection and dose prescription remain unresolved in pediatric continuous kidney replacement therapy (CKRT). Pediatric trials are scarce, so practice extrapolates from adult evidence, while 2026 KDIGO and Surviving Sepsis Campaign updates have reopened debate.
Ronco's 2000 trial established an "at least 35 mL/kg/h" paradigm after showing improved survival with higher ultrafiltration, later refuted by the large ATN and RENAL trials, which found no survival benefit from higher intensity and more complications. KDIGO 2012 therefore recommended a delivered dose of 20-25 mL/kg/h, unchanged in the 2026 draft, which additionally now recommends against high-volume hemofiltration (HVHF) in adult septic AKI, reflecting negative IVOIRE trial and Cochrane review findings.
For modality, CVVHDF has become dominant in the WE-ROCK pediatric registry, rising from 30% to 76% of prescriptions, though some favor CVVH for convective clearance; no modality shows a survival advantage. For dose, the 2026 KDIGO draft newly defines pediatric practice points: weight- rather than surface-area-based prescription to avoid inadvertent infant overdosing, initial effluent of 25-30 mL/kg/h, augmented dosing to 200 mL/kg/h for hyperammonemia, and an ultrafiltration-rate of maximal 2.5ml/kg/h. WE-ROCK data show prescribed doses far exceeding these targets without an observed dose-outcome association.
Adding to this uncertainty, the 2026 pediatric Surviving Sepsis Campaign guideline newly recommends HVHF (>35 mL/kg/h) in septic shock, conditionally and with low certainty, reversing its 2020 position on a fragile three-trial meta-analysis (Fragility Index=1)-contrasting with adult evidence and the concurrent adult KDIGO recommendation against HVHF. Given risks such as dialytrauma and drug underdosing, this fragile signal warrants cautious application.
This session invites participants to weigh this evidence and build a practical framework for individualizing modality and dose decisions at the bedside.
Yu-Wei ChenTaiwan
Moderator
Initiating Acute PD in the ICU: What Actually Works in Practice
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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
Room 101D
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