Programme

• 07:30

  08:15
  How do I Manage Patients with Acute Liver Failure
  Kathleen LiuUnited States Speaker How do I Manage Patients with Combined Kidney and Liver FailureKidney-Ventilator Interactions and Kidney Protective Ventilation /or Lung and Kidney CrosstalkHow Do I Care for the Patient with ARDS and AKIDe-escalating and Transitioning RRT: Best Practices

  Mitra NadimUnited States Speaker 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

  ChingChiao HuangTaiwan Presenter

• 07:30

  08:15
  Practical Steps to Train (and Become) an AI-Era Physician
  Kianoush KashaniUnited States Speaker Practical Steps to Train (and Become) an AI-Era PhysicianAI in Critical Care Nephrology — State of the Art and the Path from Algorithm to BedsideCritical Care Nephrology: Literature ReviewChat GPT Applications in Critical Care Nephrology

  Rolando Claure-Del GranadoBolivia Speaker 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.

  Chih-Ning ChenTaiwan Presenter

• 07:30

  08:15
  Severe Hypernatremia and Hyperkalemia in AKI Requiring KRT
  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

  Chingyu WangTaiwan Presenter

  TING HSUAN CHANGTaiwan Presenter

• 08:30

  08:50
  Welcome & Opening remarks
  Ravindra MehtaUnited States Speaker

  Jin-Shuen ChenTaiwan Speaker

  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.
• 08:50

  09:05
  Organ Crosstalk in AKI
  Kent DoiJapan Speaker Organ Crosstalk in AKIAcute kidney injury (AKI) is frequently complicated by distant organ dysfunction, significantly increasing patient morbidity and mortality. Recent clinical and experimental evidence highlights complex inter-organ crosstalk mechanisms, such as systemic cytokine release, oxidative stress, immune dysregulation, and damage-associated molecular patterns (DAMPs), that mediate extrarenal tissue injury. Experimental studies demonstrate distinct pathophysiological axes connecting the injured kidney with the heart and lungs. Specifically, mitochondrial dysfunction plays a critical role in acute cardiorenal syndrome. Furthermore, in AKI-induced acute lung injury, in addition to activation of the HMGB1–Toll-like receptor 4 (TLR4) pathway and formation of neutrophil extracellular traps (NETs), recent studies have reported a novel pathophysiological mechanism of impaired gas exchange mediated by neutrophil retention. This presentation provides an updated overview of the molecular pathways driving AKI-induced distant organ crosstalk, emphasizing key pathophysiology involving the heart and lungs, and discusses targeted therapeutic strategies to improve clinical outcomes in multi-organ failure.Heterogeneity and Future Direction of Major Adverse Kidney EventsThe "AKI/AKD/CKD axis" represents a critical continuum in nephrology, highlighting that acute kidney injury (AKI) is not merely a self-limiting episode but a potent driver of chronic kidney disease (CKD). Numerous clinical studies have reported the epidemiology of the AKI-to-CKD transition, demonstrating how recurrent or severe AKI accelerates renal decline. Crucially, methodological heterogeneity in defining Major Adverse Kidney Events (MAKE), as highlighted by our recent scoping review (Maeda et al., Intensive Care Med 2024), complicates the interpretation of clinical trial outcomes. To ensure the success of future clinical trials targeting AKI and the AKI-to-CKD transition, we must not only identify optimal therapeutic targets, but also establish standardized outcomes that directly align with improved patient care.Targeted Polymyxin B Hemadsorption in Sepsis: Lessons from Japanese Experience and Patient SelectionPolymyxin B haemadsorption (PMX-HA) has a long clinical history in Japan in the treatment of endotoxemia and septic shock. However, recent international randomized controlled trials and clinical guidelines have caused controversy regarding its routine use, citing inconsistent survival benefits in unselected populations. This presentation reviews the evolution of PMX-HA, from its origins in extensive Japanese clinical experience to modern precision medicine approaches in intensive care. Recent secondary analyses and real-world studies have highlighted significant heterogeneity in treatment effects, underscoring the necessity of appropriate patient selection. Subgroup analyses from the EUPHRATES trial demonstrated the potential efficacy of PMX-HA in patients with moderate-to-high endotoxin activity levels (EAA 0.6–0.9) and high severity of organ failure. Furthermore, machine learning applications such as causal forest modelling on large observational and trial cohorts have successfully identified specific biomarker profiles and clinical characteristics that define true responders.
• 09:05

  09:20
  Kidney-Ventilator Interactions and Kidney Protective Ventilation /Lung and Kidney Crosstalk
  Kathleen LiuUnited States Speaker How do I Manage Patients with Combined Kidney and Liver FailureKidney-Ventilator Interactions and Kidney Protective Ventilation /or Lung and Kidney CrosstalkHow Do I Care for the Patient with ARDS and AKIDe-escalating and Transitioning RRT: Best Practices
• 09:20

  09:35
  Hepatorenal Syndrome: Recognition and Management or Disordered Physiology or Iatrogenic Failure
  Mitra NadimUnited States Speaker 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
• 09:35

  10:05
  Special Lecture: 50 Years of CRRT: A Journey Through Innovation
  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)
• 10:05

  10:15
  Q & A

• 08:30

  09:10
  From AKI to Recovery: Medication Reconciliation and Polypharmacy Management
  Chia-Chi ChenTaiwan Speaker From AKI to Recovery: Medication Reconciliation and Polypharmacy Management1. Overview of Kidney-Protective and Nephrotoxic Medications 2. Medication Reconciliation and Polypharmacy Management 3. Medication Assessment and Optimization During AKI 4. Medication Review After AKI Recovery; When to Resume Kidney-Protective Therapies

  Shu-Wen LinTaiwan Moderator
• 09:10

  09:50
  Cardio-Renal Syndrome in the ICU: Pharmacological Challenges in Multi-Organ Support
  Ya-Tzu ChangTaiwan Speaker Cardio-Renal Syndrome in the ICU: Pharmacological Challenges in Multi-Organ SupportThis lecture will provide an overview of pharmacological management in cardiorenal syndrome and discuss its clinical application and therapeutic dilemmas through case-based discussion. Cardiorenal syndrome refers to a pathophysiological condition in which dysfunction of the heart or kidney induces acute or chronic dysfunction in the other organ. Pharmacological strategies include decongestion therapy and medications with cardiorenal protective effects, such as RAAS inhibitors, ARNIs, MRAs, and SGLT2 inhibitors. In clinical practice, treatment decisions must consider the patient’s hemodynamic status, renal function, electrolyte abnormalities, and overall clinical stability. The goal is to balance therapeutic benefits and potential harms while optimizing cardiac and renal protection in critically ill patients.

  Chian-Ying ChouTaiwan Moderator
• 09:50

  10:10
  Coffee Break
• 10:10

  10:50
  Nephrotoxic Drug Stewardship (NDS): Leveraging Real-World Data for AKI Prevention
  Yi-Ming HuaTaiwan Speaker Nephrotoxic Drug Stewardship (NDS): Leveraging Real-World Data for AKI Prevention藥物及腎毒性物質暴露是住院病人急性腎損傷（AKI）重要且可介入的危險因子。腎毒性藥物管理（NDS）並非單純停用腎毒性藥物，而是透過腎功能動態監測、腎毒性負荷評估、劑量調整、治療藥物監測、交互作用辨識、替代藥物選擇及用藥整合，在治療效益與腎臟安全之間取得平衡。電子病歷中的腎功能、用藥暴露、藥物濃度、共病及臨床結局等真實世界資料，可用於建立高風險分層與臨床決策支援。然而，單獨的電子警示未必能改善結果，必須結合具體可執行的建議、藥師介入及跨專業追蹤。本演講將以腎功能相關劑量調整及多重腎毒性藥物暴露為例，說明如何建立「風險辨識、即時介入、成效追蹤、回饋改善」的 NDS 模式，以降低藥物相關 AKI，同時維持必要治療的有效性。

  Hui-Chen SuTaiwan Moderator
• 10:50

  11:30
  Optimizing Pre-ESRD Care: Impact of Pharmacist-Led Clinics
  Yen-Hao LiaoTaiwan Speaker Optimizing Pre-ESRD Care: Impact of Pharmacist-Led ClinicsChronic kidney disease (CKD) is associated with complex medication regimens, polypharmacy, and an increased risk of drug-related problems, particularly in patients with pre-end-stage renal disease (Pre-ESRD). This session will highlight the role of pharmacist-led clinics in optimizing medication therapy management within a multidisciplinary care model. Drawing on real-world clinical experience and research findings, the presentation will discuss how pharmacist interventions can improve medication adherence, identify and resolve drug-related problems, reduce inappropriate medication use, and support better clinical outcomes. The session will also explore the evolving role of clinical pharmacists in delivering patient-centered care and enhancing the quality of Pre-ESRD management.

  Hui-Yu ChenTaiwan Moderator
• 11:30

  12:10
  Using Meta-Analysis to Evaluate the Risk of AKI Associated with IVI Drugs
  Shih-Chieh ShaoTaiwan Speaker Using Systematic Review and Meta-Analysis to Evaluate the Risk of AKI Associated with IVI DrugsIntravitreal anti-vascular endothelial growth factor (anti-VEGF) drugs are widely used to treat retinal diseases, but concerns remain regarding their potential systemic effects, including acute kidney injury (AKI). This presentation will demonstrate how systematic review and meta-analysis can be applied to evaluate rare safety outcomes associated with intravitreal therapies.

  Kai-Cheng ChangTaiwan Moderator
• 12:10

  12:25
  Panel Discussion & Q&A

• 09:00

  09:50
  AKI跨領域團隊協作：結合院內警示系統與病人心理照護之整合模式
  Tzu-Chun ChenTaiwan Speaker AKI跨領域團隊協作：結合院內警示系統與病人心理照護之整合模式急性腎損傷（Acute Kidney Injury, AKI）病人常因腎功能於短時間內惡化，面臨病情不確定、治療調整、可能接受腎臟替代療法及後續追蹤等壓力。AKI照護不僅需要即時醫療處置，更仰賴跨領域團隊透過資訊系統、臨床判斷與照護溝通，及早辨識高風險病人並啟動適切介入。 本次分享將以院內AKI警示系統推動經驗為核心，分享臨床如何運用燈號分級管理協助團隊掌握病人狀態。其中，黃色燈號代表系統出現AKI警示，提醒臨床團隊需提高警覺、追蹤腎功能變化並評估潛在風險；紅色燈號代表病人已有腎功能異常，但尚未由腎臟科收案，需進一步強化通報、評估與跨團隊銜接；綠色燈號則代表病人已由腎臟科收案，進入持續追蹤與專科共同照護流程。透過此分級機制，醫療團隊可更清楚掌握AKI病人之照護進程，降低風險辨識落差與照護延遲。 課程內容將進一步說明跨領域團隊在AKI照護中的合作角色，包括腎臟科醫師對腎功能異常與治療方向之評估，護理師於尿量、輸出入量、生命徵象、體液狀態與用藥安全之持續監測，藥師協助檢視腎毒性藥物與劑量調整，營養師提供符合腎功能狀態之營養建議，個案管理師協助追蹤、轉銜與衛教銜接，資訊團隊則透過警示系統支持臨床決策與照護流程優化。 除生理照護外，本課程亦將納入AKI病人的心理照護觀點。當病人得知腎功能異常、病況可能惡化或需接受透析評估時，常出現焦慮、害怕、失控感、對未來生活改變的擔憂，以及對家人造成負擔的壓力。護理人員可透過同理傾聽、清楚且一致的說明、評估病人與家屬的理解程度、提供可執行的照護建議，並在治療決策過程中融入共享決策與病人賦能，協助病人降低不確定感並提升治療參與感。 本課程期望透過院內AKI警示系統、紅黃綠燈號管理、跨領域團隊協作與心理照護經驗分享，強化醫療團隊對AKI病人之即時辨識、照護銜接、專科介入與人本支持能力，進一步提升AKI照護品質、病人安全與長期腎臟健康結果。
• 09:50

  10:15
  ​​重症 CRRT 照護的核心關鍵：適應症評估與警訊早期介入​
  Shu-Chen WuTaiwan Speaker ​​重症 CRRT 照護的核心關鍵：適應症評估與警訊早期介入​ 隨著重症醫學的進步，連續性腎替代療法（CRRT）已成為加護病房（ICU）救治多重器官衰竭與急性腎損傷（AKI）病患不可或缺的核心技術。本講座將引領與會者回顧 CRRT 的發展演進，從早期的基本血液淨化演進至當前精準的重症支持療法。內容將深入探討 CRRT 在加護病房中的關鍵臨床適應症，包括嚴重的體液過載、電解質與酸鹼失衡、以及敗血症引起的全身性發炎反應等處置決策。 此外，CRRT 治療過程中的機台警訊往往瞬息萬變，如何「早期發現、即時干預」是決定治療成敗與維持管路壽命的護理關鍵。本堂課將結合理論與近三十年的重症與透析臨床實務經驗，系統性解析常見的 CRRT 警訊（如跨膜壓高、動靜脈壓力異常等）之背後成因與臨床處置技巧。期能協助重症照護團隊建立預警思維，在警訊發生初期即能精準介入，優化重症病患的治療成效與照護品質。
• 10:15

  10:40
  重症 CRRT從異常警報排除到跨團隊支持協作
  Li-Ming WuTaiwan Speaker 重症 CRRT從異常警報排除到跨團隊支持協作一、 進階臨床實務訓練（Simulation Training）上一堂課學到的「警報定義」與「併發症」，轉化為床邊執行的直覺反應。 （一）高壓/低壓警報的即時處置模擬：模擬動靜脈壓力異常（Access/Return Pressure）的床邊排除技巧。超濾率（Ultrafiltration）偏差與跨膜壓（TMP）過高的應變處置。 （二）無預警斷電或機件故障危機處理自動回血功能失效時，如何切換為「手動回血」流程，確保病人血液不流失 。 （三）極致管路與濾器防凝血策略：針對容易凝血的高風險病人，深入演練抗凝劑（如 Heparin 或局部檸檬酸抗凝法 Regional Citrate Anticoagulation, RCA）的精準劑量調控與床邊監測 。 二、 CRRT 跨團隊照護協作（Multidisciplinary Collaboration）： （一）醫護共同決策 ──「早期啟動」與「動態撤離」：建立 ICU 重症醫師與護理師的共同語言，依據病人的血流動力學變化的關鍵指標，動態調整治療參數 。 （二）護藥聯手 ── 藥物劑量動態精準調整（重症藥師協作）：延續上一堂提到的「低分子量與游離態藥物易被清除」之痛點 。 核心訓練： 如何與重症藥師配合，針對抗生素（如 Vancomycin、Meropenem）在 CRRT 運作期間進行動態血中濃度監測（TDM）與劑量補償，避免治療濃度不足 。 （三）護營協作 ── 高流量透析下的營養支持（營養師協作）：針對簡報提及「確保足夠營養支持」 進行具體實作。 重症營養師如何評估 CRRT 清除掉的氨基酸與微量元素，精準計算並給予適當的靜脈/腸道營養配方（TPN/EN） 。 三、 跨團隊溝通與危急資源管理（CRM）重症團隊的關鍵溝通（Structured Communication）：運用 ISBAR 溝通工具，在病人血壓崩潰 、嚴重酸中毒 或大量漏血 的危急時刻，護理師如何向醫師團隊精確回報，引導團隊快速決策。 交班盲點與連續性照護品質（Quality Indicator）：制定 ICU 白班、夜班，以及血液透析室護理師之間的優化交班檢核表（Checklist），包含管路壽命評估、累積出入量平衡（Fluid Balance）的交接 。
• 10:40

  11:05
  AKI 病人血液透析期間照護決策
  Chiung-Yu ShihTaiwan Speaker AKI病人血液透析期間照護決策急性腎損傷(Acute kidney injury, AKI)是住院病人(約5%~10%)中常出現的疾病，尤其是重症病人(約60%)伴隨有多重共病症者，其發生原因甚多，且會明顯增加病人的發病率和死亡率，不應被視為單一疾病；其臨床處置需更瞭解體液和電解質的平衡，給予評估及決策適當的透析治療模式；然其模式決策的選擇，應依血流動力學的穩定性進行評估。不穩定者優先採用連續性腎臟替代治療（CRRT）或緩慢低效率每日血液透析過濾術(SLEDD-f)，以降低心血管負荷；穩定者則可選用間歇性血液透析（IHD），避免透析中低血壓，造成腎臟再次缺血損傷；同時需每日評估並滾動式調整透析醫囑與電解質參數，維持治療穩定安全。 綜論，建立標準化的AKI預防處置，抉擇適當的透析治療策略及臨床照護，確保病人安全，在清除素毒與血流動力學穩定下，阻斷AKI的病程，以促進腎功能的恢復。 課程重點大綱:1.AKI病人透析適應症判斷 2.透析模式選擇 3.透析期間常見併發症 4.護理決策與即時處置
• 11:05

  11:30
  急性腎損傷病人血液透析的照護缺口：第一線護理師的臨床決策與實務分享
  Li-Hua TsaiTaiwan Speaker 急性腎損傷病人血液透析的照護缺口：第一線護理師的臨床決策與實務分享臨床實務上，發對於急性腎損傷（AKI）病人血液透析的照護缺乏系統化的指引，導致前、中、後期的照護決策流於破碎與被動執行醫囑。本次報告將從第一線臨床實務出發，分享如何建構「三階段全期護理照護決策地圖」。內容橫跨三核心階段：(1) 啟動期扮演安全守門員，結合生理數據給予個體化透析處方建議；(2)透析中利用早期預警指標，在低血壓發生前主動決策介入，嚴防二次腎損傷；(3)返家/出院期透過結構化照護，延續病人自我管理。期盼藉由本次現狀分享與交流，推動標準化照護共識，彰顯護理人員在動態決策中的關鍵價值，進而優化AKI病人的臨床預後。
• 11:30

  11:45
  AKI-to-CKD 智能照護流程建構與實務成效
  I-Chen LeeTaiwan Speaker AKI-to-CKD 智能照護流程建構與實務成效急性腎損傷（Acute Kidney Injury, AKI）為住院病人常見且高風險之臨床問題，若未及早辨識與介入，可能進展為急性腎臟病（AKD）甚至慢性腎臟病（CKD），增加透析、再住院及死亡風險。本院透過資訊系統整合，建立 AKI E-alert System，利用住院、急診及門診血清肌酸酐（Serum Creatinine）變化，自動比對基準值，依據 KDIGO 標準進行 AKI 分期與警示，提升臨床團隊對 AKI 病人的即時辨識能力。進一步結合台灣健保 AKD 與 CKD 照護條件，建置 CKD MAP，並導入 One Team 住院個案管理系統，整合腎臟科醫師、個管師、護理師、藥師及營養師跨團隊照護流程。系統可自動篩選符合收案條件之病人，協助個案管理介入、腎毒性藥物檢視、營養與衛教評估，以及出院後 AKD/CKD 門診追蹤轉介，建立完整 AKI-to-CKD 照護鏈結。本次分享將介紹本院 AKI 智能警示系統架構、AKD照護流程設計、跨團隊照護模式及資訊整合策略，並呈現導入後之收案率、腎臟科會診率、個案追蹤率及照護效益成果。期望透過數位轉型與精準照護模式，提升 AKI 病人早期介入與長期腎臟保護成效，作為未來 AKI-to-CKD 整合照護之實務參考。
• 11:45

  12:00
  急性腎損傷個案管理策略
  Chiao-Chuan HuangTaiwan Speaker 急性腎損傷個案管理策略本院推行以病人為中心之急性腎損傷個案管理策略，落實跨團隊衛教機制，強化病人對疾病進程的認知，以提升定期接受腎臟專科追蹤之遵從性。護理師教導AKD惡化因子及日常照護，並建立用藥安全觀念，如：避免自行服用 NSAIDs 等腎毒性藥物。導入智能化資訊系統主動篩選符合條件病人，即時提示醫療團隊進行AKD照護，本照護模式透過「病人自主、醫護精準、資訊智能」期能達到早期發現、即時介入，以降低 AKD惡化為慢性腎臟病（CKD）之風險。
• 12:00

  12:15
  衛教師經驗分享：衛教師的角色與實務觀點
  Tsung-Lin WuTaiwan Speaker 衛教師經驗分享：衛教師的角色與實務觀點
• 12:15

  12:20
  Q&A

• 10:45

  11:00
  Opening Ceremony
• 11:00

  11:15
  Sepsis Associated AKI
  Lui ForniUnited Kingdom Speaker Sepsis Associated AKIBicarbonate in AKI: Use and MisuseAdapting CRRT for Patients with Electrolyte and ACID-Base Disorders
• 11:15

  11:30
  Role of Renal Functional Reserve on AKI Risk and Recovery
  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)
• 11:30

  11:45
  AKI in the Mechanical Circulatory Support
  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.
• 11:45

  12:15
  Special Lecture: Key Updates in the 2026 KDIGO AKI/AKD Guideline
  Jay KoynerUnited States Speaker Special lecture: 2026 KDIGO AKI Guideline UpdateI will be updating the audience on the major conceptual updates of the 2026 KDIGO AKI Guidelines. I will focus on Chapter 1 and 2, including the evolving definition of AKI/AKD, AKI trajectories, biomarkers, and risk prediction, together with selected key updates from Chapter 4 on nephrotoxin-associated kidney injuryTargeting Persistent AKI and Promoting RecoveryI have been working with my co-moderators to develop a case based presentation looking at the use of biomarkers to predict outcomes in a patient with dialysis requiring AKI. and we will be discussing the intracicies of providing AKI-care to those receiving dialysis and how best to wean patients from dialysis and the long term outpatient managment of these patients
• 12:15

  12:25
  Q & A

• 12:40

  13:05
  Precision CRRT: Raising the Bar in AKI Care
  Jay KoynerUnited States Speaker Special lecture: 2026 KDIGO AKI Guideline UpdateI will be updating the audience on the major conceptual updates of the 2026 KDIGO AKI Guidelines. I will focus on Chapter 1 and 2, including the evolving definition of AKI/AKD, AKI trajectories, biomarkers, and risk prediction, together with selected key updates from Chapter 4 on nephrotoxin-associated kidney injuryTargeting Persistent AKI and Promoting RecoveryI have been working with my co-moderators to develop a case based presentation looking at the use of biomarkers to predict outcomes in a patient with dialysis requiring AKI. and we will be discussing the intracicies of providing AKI-care to those receiving dialysis and how best to wean patients from dialysis and the long term outpatient managment of these patients
• 13:05

  13:30
  From Data to Action: Enhancing CRRT Quality and Outcomes
  Kianoush KashaniUnited States Speaker Practical Steps to Train (and Become) an AI-Era PhysicianAI in Critical Care Nephrology — State of the Art and the Path from Algorithm to BedsideCritical Care Nephrology: Literature ReviewChat GPT Applications in Critical Care Nephrology
• 13:30

  13:45
  Panel Discussion

• 12:40

  12:45
  Opening
• 12:45

  13:15
  Optimizing Regional Citrate Anticoagulation: Simplified Approach to Protocol Selection and Management of Challenging Patients
  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?
• 13:15

  13:45
  Practical Considerations for Implementiing 4%TSC Procotol with Clinical Case Sharing and Expert Panel Discussion
  Soo Lee Ying Speaker
• 13:45

  13:50
  Q & A

• 12:40

  12:45
  Opening
• 12:45

  13:30
  The Rationale for Hemoadsorption in the Critically Ill: Sepsis and Beyond
  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.
• 13:30

  13:45
  Q & A

• 12:40

  12:50
  Opening Remark
• 12:50

  13:35
  輸液組成的重要性：水分、電解質與酸鹼平衡的臨床思考
  Ming-Jen ChanTaiwan Speaker
• 13:35

  13:45
  Panel Discussion & Closing Remarks

• 14:00

  14:10
  Opening
  Wei-Lun LiuTaiwan Speaker
• 14:10

  15:00
  Overview of Acute Kidney Injury and Continuous Renal Replacement Therapy in Critical Care
  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

  Wei-Lun LiuTaiwan Moderator
• 15:00

  15:15
  Break
• 15:15

  15:45
  Station 1- PrisMax and ECCO2R
  Chih-Heng ChangTaiwan Speaker PrisMax and ECCO2R demoThe session provides a comprehensive, hands-on demonstration of the Baxter Prismaflex/PrisMax system integrated with extracorporeal carbon dioxide removal (ECCO₂R) technology. Participants will gain practical experience with the operational principles of ECCO₂R, including membrane lung mechanics, CO₂ diffusion dynamics, and factors influencing clearance efficiency. Through guided instruction, learners will explore how blood flow, sweep gas settings, and membrane characteristics interact to optimize CO₂ removal in various clinical scenarios. In addition to theoretical concepts, the workshop emphasizes real-world application. Participants will practice of the PrisMax platform. The session also highlights patient monitoring strategies, including assessment of ventilation status, acid–base balance, hemodynamics, and anticoagulation requirements. By the end of the training, attendees will be familiar with the practical workflow of ECCO₂R therapy, understand its clinical indications such as hypercapnic respiratory failure or lung-protective ventilation strategies, and be able to integrate PrisMax system operation into routine critical care practice. This hands-on experience is designed to strengthen both technical proficiency and clinical decision-making for healthcare professionals involved in advanced respiratory support.

  Wei-Lun LiuTaiwan Moderator
• 15:45

  16:15
  Station 2- APAC Oxiris Expert Consensus Briefing
  I-Hsien LeeTaiwan Speaker APAC Oxiris Expert Consensus briefing• APAC 專家共識重點解析 • 著重於敗血症與發炎反應治療應用 • 協助理解何時使用、如何選擇 第二站聚焦於Oxiris相關之國際專家共識解讀，說明其在敗血症及重症發炎反應中的使用策略，協助醫療人員理解治療時機與選擇依據。

  Wei-Lun LiuTaiwan Speaker
• 16:15

  16:45
  Station 3 – Practical CRRT Prescription and Regional Citrate Anticoagulation
  Bo-Tang WangTaiwan Speaker 檸檬酸抗凝治療, CRRT處方設定原則本課程將介紹檸檬酸局部抗凝在連續性腎臟替代治療（CRRT）中的原理、應用與臨床操作要點。內容涵蓋檸檬酸抗凝原理、鈣離子監測與補充策略，以及常見併發症如低鈣血症、代謝性酸鹼中毒的處置。課程亦將透過案例討論協助學員理解參數設定與調整原則，提升 CRRT 治療安全性與療效。

  Wei-Lun LiuTaiwan Moderator
• 16:45

  17:00
  Closing
  Wei-Lun LiuTaiwan Speaker

• 14:00

  14:05
  Chair's Opening: Framing AI + Big Data Along the AKI/CRRT Care Pathway
  Chia-Chao WuTaiwan Speaker

  Chin-Chung TsengTaiwan Speaker
• 14:05

  14:20
  Korean Big-Data Experience in AKI and CRRT Outcomes
  Sejoong KimSouth Korea Speaker Korean Big-Data Experience in AKI and CRRT OutcomesSouth Korea has established a robust nationwide health data infrastructure, enabling large-scale analyses of acute kidney injury (AKI) and continuous renal replacement therapy (CRRT). Leveraging the Health Insurance Review and Assessment Service (HIRA) and National Health Insurance Service (NHIS) databases, Korean researchers have characterized AKI incidence, risk factors, and short- and long-term outcomes across diverse clinical settings. Studies utilizing CRRT data have identified predictors of mortality, renal recovery, and progression to chronic kidney disease. These big-data approaches provide critical real-world evidence, informing clinical practice and guiding future interventional strategies in critically ill patients with AKI.Precision Volume Management in CRRT: Insights from Bioimpedance and BiomarkersOptimal fluid balance is critical in critically ill patients undergoing continuous renal replacement therapy (CRRT), yet accurate volume assessment remains challenging. Bioimpedance analysis (BIA) offers a non-invasive, objective method to quantify fluid overload and guide individualized ultrafiltration targets. Complementing BIA, emerging biomarkers provide dynamic, real-time insights into volume status and end-organ perfusion. Integrating these tools into a precision medicine framework may optimize fluid removal strategies, reduce complications, and improve survival outcomes in CRRT-dependent patients. Prospective validation of this combined approach is warranted.
• 14:20

  14:35
  Deep Learning ECG as a Non-Invasive Window into Kidney Function and Electrolytes
  Chin LinTaiwan Speaker Deep Learning Electrocardiography as a Non-Invasive Window into Kidney Function and Electrolyte DisturbancesRecent advances in deep learning have transformed the standard 12-lead electrocardiogram (ECG) from a tool for rhythm interpretation into a scalable physiologic sensor capable of detecting systemic disease. In this lecture, we will review the development and clinical translation of AI-enabled ECG models for dyskalemia detection and renal-function estimation. Using large real-world cohorts, convolutional and attention-based neural networks have demonstrated high accuracy for identifying moderate-to-severe hyperkalemia and hypokalemia directly from ECG waveforms, frequently preceding laboratory confirmation and outperforming clinician interpretation. Beyond electrolyte detection, AI-ECG signatures were also associated with adverse outcomes, cardiovascular risk, and future chronic kidney disease progression, even among patients with apparently normal laboratory findings. We will further discuss pragmatic deployment studies showing how real-time AI-ECG alerts integrated into emergency department workflows can accelerate treatment decisions for life-threatening hyperkalemia. Finally, the talk will address how signal-based AI can complement EHR-based prediction models in critical-care nephrology, including issues of interpretability, calibration drift, implementation, and multimodal foundation-model integration.
• 14:35

  14:50
  AI in Critical Care Nephrology — State of the Art and the Path from Algorithm to Bedside
  Kianoush KashaniUnited States Speaker Practical Steps to Train (and Become) an AI-Era PhysicianAI in Critical Care Nephrology — State of the Art and the Path from Algorithm to BedsideCritical Care Nephrology: Literature ReviewChat GPT Applications in Critical Care Nephrology
• 14:50

  15:05
  Precision Sepsis-AKI — Biomarkers, AI and Phenotyping in the Asia-Pacific
  Nattachai SrisawatThailand Speaker Precision Sepsis-AKI — Biomarkers, AI and Phenotyping in the Asia-PacificSepsis-associated AKI in the Asia-Pacific carries a burden that global datasets underrepresent. In the SEA-AKI prospective multicentre ICU study, AKI was very common, with stage 3 reaching 28.9%, and infectious disease among the independent risk factors for AKI development. In the InSEA-RRT registry — 2,315 critically ill patients with stage 3 AKI across 24 hospitals in Southeast Asia and India — 47% died during hospitalization, with major adverse kidney events tracked to two years. These cohorts expose the limits of treating sepsis-AKI as one disease. This lecture examines how damage and stress biomarkers, machine-learning models trained on regional rather than imported data, and sub-phenotyping by trajectory and host response can move us from a single creatinine-based label toward actionable patient groups. Emphasis will be on what is deployable in resource-variable settings, where biomarker access is uneven and registry infrastructure is often the practical starting point for precision medicine.Timing of DialysisWhen to start kidney replacement therapy (KRT) in AKI remains one of the most frequent bedside decisions in critical care, and the trial evidence has settled less than it first appears. ELAIN favoured early initiation, AKIKI and IDEAL-ICU did not, STARRT-AKI showed no survival benefit from an accelerated strategy with more dialysis dependence at 90 days, and AKIKI-2 found that delaying further offered no advantage and may cause harm. This session works through illustrative cases rather than trial summaries: the patient with rising creatinine but no urgent indication, refractory hyperkalaemia or acidosis demanding immediate treatment, the fluid-overloaded patient with worsening oxygenation, and the diuretic-responsive patient in whom watchful waiting proves correct. Each case is used to separate absolute indications from the discretionary zone where trials apply. Emphasis will be on practical decision aids — urine output trajectory, furosemide stress testing, fluid balance, and organ-support burden — and on when not starting is the better decision.Acute PD vs Acute HD: Which Is the Right Choice?For AKI requiring kidney replacement therapy outside well-resourced ICUs, the practical question is which modality can be started safely tonight. Acute peritoneal dialysis (PD) needs no vascular access, anticoagulation, water treatment, or machine, but concerns persist about clearance and ultrafiltration control. Our multicentre randomized trial assigned 157 patients with AKI to lower-dosage acute PD (18–24 L/day) or intermittent hemodialysis three times weekly. Sepsis caused 68% of AKI. Twenty-eight-day mortality was 50% versus 49% (risk difference 0.6%), meeting the prespecified noninferiority margin, with comparable dialysis-free survival and seven-day fluid balance. Complications diverged rather than favoured one modality: intradialytic hypotension was more frequent with hemodialysis, hypokalemia with PD. This lecture translates these findings into practice — where lower-dosage PD is a legitimate first choice, where it is not, how to prescribe and monitor it, and how modality availability shapes AKI preparedness in resource-limited settings.
• 15:05

  15:25
  Panel Discussion
  Chin LinTaiwan Speaker Deep Learning Electrocardiography as a Non-Invasive Window into Kidney Function and Electrolyte DisturbancesRecent advances in deep learning have transformed the standard 12-lead electrocardiogram (ECG) from a tool for rhythm interpretation into a scalable physiologic sensor capable of detecting systemic disease. In this lecture, we will review the development and clinical translation of AI-enabled ECG models for dyskalemia detection and renal-function estimation. Using large real-world cohorts, convolutional and attention-based neural networks have demonstrated high accuracy for identifying moderate-to-severe hyperkalemia and hypokalemia directly from ECG waveforms, frequently preceding laboratory confirmation and outperforming clinician interpretation. Beyond electrolyte detection, AI-ECG signatures were also associated with adverse outcomes, cardiovascular risk, and future chronic kidney disease progression, even among patients with apparently normal laboratory findings. We will further discuss pragmatic deployment studies showing how real-time AI-ECG alerts integrated into emergency department workflows can accelerate treatment decisions for life-threatening hyperkalemia. Finally, the talk will address how signal-based AI can complement EHR-based prediction models in critical-care nephrology, including issues of interpretability, calibration drift, implementation, and multimodal foundation-model integration.

  Kianoush KashaniUnited States Speaker Practical Steps to Train (and Become) an AI-Era PhysicianAI in Critical Care Nephrology — State of the Art and the Path from Algorithm to BedsideCritical Care Nephrology: Literature ReviewChat GPT Applications in Critical Care Nephrology

  Nattachai SrisawatThailand Speaker Precision Sepsis-AKI — Biomarkers, AI and Phenotyping in the Asia-PacificSepsis-associated AKI in the Asia-Pacific carries a burden that global datasets underrepresent. In the SEA-AKI prospective multicentre ICU study, AKI was very common, with stage 3 reaching 28.9%, and infectious disease among the independent risk factors for AKI development. In the InSEA-RRT registry — 2,315 critically ill patients with stage 3 AKI across 24 hospitals in Southeast Asia and India — 47% died during hospitalization, with major adverse kidney events tracked to two years. These cohorts expose the limits of treating sepsis-AKI as one disease. This lecture examines how damage and stress biomarkers, machine-learning models trained on regional rather than imported data, and sub-phenotyping by trajectory and host response can move us from a single creatinine-based label toward actionable patient groups. Emphasis will be on what is deployable in resource-variable settings, where biomarker access is uneven and registry infrastructure is often the practical starting point for precision medicine.Timing of DialysisWhen to start kidney replacement therapy (KRT) in AKI remains one of the most frequent bedside decisions in critical care, and the trial evidence has settled less than it first appears. ELAIN favoured early initiation, AKIKI and IDEAL-ICU did not, STARRT-AKI showed no survival benefit from an accelerated strategy with more dialysis dependence at 90 days, and AKIKI-2 found that delaying further offered no advantage and may cause harm. This session works through illustrative cases rather than trial summaries: the patient with rising creatinine but no urgent indication, refractory hyperkalaemia or acidosis demanding immediate treatment, the fluid-overloaded patient with worsening oxygenation, and the diuretic-responsive patient in whom watchful waiting proves correct. Each case is used to separate absolute indications from the discretionary zone where trials apply. Emphasis will be on practical decision aids — urine output trajectory, furosemide stress testing, fluid balance, and organ-support burden — and on when not starting is the better decision.Acute PD vs Acute HD: Which Is the Right Choice?For AKI requiring kidney replacement therapy outside well-resourced ICUs, the practical question is which modality can be started safely tonight. Acute peritoneal dialysis (PD) needs no vascular access, anticoagulation, water treatment, or machine, but concerns persist about clearance and ultrafiltration control. Our multicentre randomized trial assigned 157 patients with AKI to lower-dosage acute PD (18–24 L/day) or intermittent hemodialysis three times weekly. Sepsis caused 68% of AKI. Twenty-eight-day mortality was 50% versus 49% (risk difference 0.6%), meeting the prespecified noninferiority margin, with comparable dialysis-free survival and seven-day fluid balance. Complications diverged rather than favoured one modality: intradialytic hypotension was more frequent with hemodialysis, hypokalemia with PD. This lecture translates these findings into practice — where lower-dosage PD is a legitimate first choice, where it is not, how to prescribe and monitor it, and how modality availability shapes AKI preparedness in resource-limited settings.

  Sejoong KimSouth Korea Speaker Korean Big-Data Experience in AKI and CRRT OutcomesSouth Korea has established a robust nationwide health data infrastructure, enabling large-scale analyses of acute kidney injury (AKI) and continuous renal replacement therapy (CRRT). Leveraging the Health Insurance Review and Assessment Service (HIRA) and National Health Insurance Service (NHIS) databases, Korean researchers have characterized AKI incidence, risk factors, and short- and long-term outcomes across diverse clinical settings. Studies utilizing CRRT data have identified predictors of mortality, renal recovery, and progression to chronic kidney disease. These big-data approaches provide critical real-world evidence, informing clinical practice and guiding future interventional strategies in critically ill patients with AKI.Precision Volume Management in CRRT: Insights from Bioimpedance and BiomarkersOptimal fluid balance is critical in critically ill patients undergoing continuous renal replacement therapy (CRRT), yet accurate volume assessment remains challenging. Bioimpedance analysis (BIA) offers a non-invasive, objective method to quantify fluid overload and guide individualized ultrafiltration targets. Complementing BIA, emerging biomarkers provide dynamic, real-time insights into volume status and end-organ perfusion. Integrating these tools into a precision medicine framework may optimize fluid removal strategies, reduce complications, and improve survival outcomes in CRRT-dependent patients. Prospective validation of this combined approach is warranted.
• 15:25

  15:30
  Chair's Synthesis and Take-Home Points
  Chia-Chao WuTaiwan Speaker

  Chin-Chung TsengTaiwan Speaker

• 14:00

  15:30
  Precision Solute Control and Dynamic Dosing with CRRT
  Manish KaushikSingapore Speaker Patient Selection, Modality, DoseAccess, Membrane, CircuitSevere Hypernatremia and Hyperkalemia in AKI Requiring KRTPrecision Solute Control and Dynamic Dosing with CRRT

  Rolando Claure-Del GranadoBolivia Speaker 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.

  Jenq-Wen HuangTaiwan Moderator

  Yung-Chang ChenTaiwan Moderator

• 14:00

  15:30
  Managing Patients With Combined Kidney and Liver Failure
  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

  Mitra NadimUnited States Speaker 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

  Ju-Yeh YangTaiwan Moderator

  Ya-Chung TianTaiwan Moderator

• 14:00

  15:30
  Managing Patients with Sepsis: Modifying the Course with ECOS
  Thomas RimmeléFrance Speaker Managing Patients with Sepsis: Modifying the Course with ECOSImmune Disorders of AKI Patients Following Various Types of Injuries ?How Do I Use Hemadsorption in My Practice

  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.

  Bang-Gee HsuTaiwan Moderator

  YU-FENG LINTaiwan Moderator

• 14:00

  15:30
  How Do I Care for the Patient with ARDS and AKI
  Kathleen LiuUnited States Speaker How do I Manage Patients with Combined Kidney and Liver FailureKidney-Ventilator Interactions and Kidney Protective Ventilation /or Lung and Kidney CrosstalkHow Do I Care for the Patient with ARDS and AKIDe-escalating and Transitioning RRT: Best Practices

  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.

  Chien-Liang ChenTaiwan Moderator

  Chien-Yu LinTaiwan Moderator

• 16:00

  16:05
  Chair's Opening: Framing Post-AKI Recovery, Critical Illness, and Regional AKD Phenotypes
  Tai-Shuan LaiTaiwan Speaker

  WEIHUNG LinTaiwan Speaker 重症腎臟醫學的能力架構：里程碑與 EPAs 重症腎臟醫學的能力架構：里程碑與可信賴專業活動（EPAs） 林威宏醫師 醫學系副系主任｜教學中心主任｜內科部副部長｜一般內科主任 成功大學醫學院附設醫院 重症腎臟醫學要求臨床醫師在高度不確定、時間敏感且跨專業的情境中，整合急性腎損傷、腎替代治療、電解質與酸鹼異常、液體與血流動力學，以及倫理與溝通等多重能力。傳統以訓練年資、授課主題或病例數為主的課程，往往無法回答最關鍵的問題：受訓醫師究竟能在何種督導程度下，安全且一致地完成真實臨床任務？ 本演講將介紹一套適用於重症醫學專科訓練的「重症腎臟醫學核心能力框架」草案。此框架以能力導向醫學教育為基礎，將 ACGME 六大核心能力整合至六個臨床領域，建構18項可信賴專業活動（entrustable professional activities, EPAs）及五階段里程碑。L4定義為完訓時可被信賴執行的目標層級；在臺灣ICU主治醫師覆核文化下，對應於間接督導及次日覆核，L5則代表完訓後的進階專家發展。七項涉及病人安全的核心任務被列為must-pass EPAs，包括腎臟替代療法的適應症與時機、CRRT處方、CRRT劑量調整與治療藥物監測、危急電解質異常、以床邊超音波及VExUS評估液體反應性與靜脈充血、敗血症相關AKI，以及腎臟替代療法撤除與緩和醫療。 評量採多工具、縱向及多來源的整合式評量，結合病例討論、mini-CEX、DOPS、模擬式OSCE、360度回饋與學習歷程；罕見但高風險的臨床情境，可由模擬、病歷回顧或結構式病例討論補足。建議的完訓門檻為七項must-pass EPAs全數達L4、18項中至少15項達L4，其餘至少達L3，並完成跨團隊品質改善成果。 此框架將訓練焦點由「教過多少、做過幾例」轉向「能否在適當督導下可靠完成臨床工作」，並透過可觀察表現、持續回饋與縱向進展，支持可辯護的信賴決策，同時為後續AI輔助學習與可信賴教育系統提供由臨床專業所界定的能力基礎。 關鍵詞：能力導向醫學教育、重症腎臟醫學、可信賴專業活動、里程碑、整合式評量 Competency Frameworks in Critical Care Nephrology: Milestones and Entrustable Professional Activities (EPAs) Wei-Hung Lin, MD, PhD Vice Chair, Department of Medicine, College of Medicine, National Cheng Kung University Director, Education Center Deputy Director, Department of Internal Medicine Chief, Division of General Internal Medicine National Cheng Kung University Hospital (NCKUH), College of Medicine, National Cheng Kung University Critical care nephrology requires clinicians to integrate acute kidney injury, renal replacement therapy, electrolyte and acid–base disorders, fluid and hemodynamic management, and ethically complex communication in time-sensitive, uncertain, and interprofessional settings. Traditional curricula based on training duration, covered topics, or case numbers do not adequately answer a fundamental question: What clinical work can a trainee be trusted to perform, and at what level of supervision? This lecture introduces a proposed competency-based framework for postgraduate training in critical care nephrology. The framework maps the six Accreditation Council for Graduate Medical Education core competencies across six clinical domains and organizes authentic workplace practice into 18 entrustable professional activities (EPAs) with five developmental milestone levels. Level 4 (L4) represents the graduation target—interpreted in the Taiwanese ICU context as indirect supervision with next-day attending review—whereas L5 denotes aspirational post-training expertise. Seven safety-critical EPAs require achievement of L4: determining the indications and timing of renal replacement therapy; prescribing continuous renal replacement therapy (CRRT); adjusting CRRT dose and therapeutic drug monitoring; managing life-threatening electrolyte disorders; assessing fluid responsiveness and venous congestion using point-of-care ultrasound (POCUS) and venous excess ultrasound (VExUS); managing sepsis-associated AKI; and leading decisions on withdrawal of renal replacement therapy and palliative care. Assessment is programmatic, longitudinal, and multisource, combining case-based discussion, mini-CEX, direct observation of procedural skills, simulation-based OSCEs, multisource feedback, and a longitudinal portfolio. Simulation, chart review, and structured case conferences can address low-frequency, high-risk clinical exposures. Proposed graduation standards require all seven must-pass EPAs and at least 15 of 18 EPAs to reach L4, with the remainder at L3 or above, plus documented interprofessional quality-improvement work. By shifting the focus from content coverage and case counting to observable performance, feedback, progression, and defensible entrustment decisions, the framework provides a clinically defined foundation for subsequent AI-enabled learning and trustworthy education systems. Keywords: competency-based medical education; critical care nephrology; entrustable professional activities; milestones; programmatic assessment
• 16:05

  16:20
  Talk 1: From AKI to AKD: Recovery Pathways and High-Risk Phenotypes
  Jia-Jin ChenTaiwan Speaker 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.
• 16:20

  16:35
  Talk 2: Can the Kidney Truly Recover After AKI? Fluid Management, Critical Illness, and the AKD Continuum
  Nurul Zaynah NordinMalaysia Speaker Can the Kidney Truly Recover After AKI? Fluid Management, Critical Illness, and the AKD Continuum
• 16:35

  16:50
  Talk 3: Immune-Mediated Repair After AKI: From Recovery to AKD Progression
  Kyungho LeeSouth Korea Speaker Drug Exposures: Concerns in Kidney Safety (PPI vs Potassiumcompetitive acid blockers (P-CABs))
• 16:50

  17:05
  Talk 4: Preventable AKI and AKD: A Philippine Perspective on Early Recognition and Risk Reduction
  Maria Erika RamirezPhilippines Speaker Preventable AKI and AKD: A Philippine Perspective on Early Recognition and Risk ReductionThis presentation examines acute kidney injury and acute kidney disease in the Philippine setting, highlighting practical, low-cost strategies for early recognition and risk reduction to prevent progression to chronic kidney disease.
• 17:05

  17:25
  Panel Discussion / Q&A: How Should Asia-Pacific Build Better Post-AKI/AKD Recovery and Prevention Pathways?
  Jia-Jin ChenTaiwan Speaker 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.

  Kyungho LeeSouth Korea Speaker Drug Exposures: Concerns in Kidney Safety (PPI vs Potassiumcompetitive acid blockers (P-CABs))

  Maria Erika RamirezPhilippines Speaker Preventable AKI and AKD: A Philippine Perspective on Early Recognition and Risk ReductionThis presentation examines acute kidney injury and acute kidney disease in the Philippine setting, highlighting practical, low-cost strategies for early recognition and risk reduction to prevent progression to chronic kidney disease.

  Nurul Zaynah NordinMalaysia Speaker Can the Kidney Truly Recover After AKI? Fluid Management, Critical Illness, and the AKD Continuum
• 17:25

  17:30
  Chair's Synthesis and Take-Home Points
  Tai-Shuan LaiTaiwan Speaker

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

• 16:00

  16:15
  Trajectories of Critical Illness – Defining Endotypes from Routine Data
  John ProwleUnited Kingdom Speaker Trajectories of Critical Illness – Defining Endotypes from Routine DataCritical illness is a heterogeneous syndrome characterized by diverse clinical trajectories and variable responses to treatment. Defining biologically and clinically meaningful endotypes using routinely collected healthcare data offers an opportunity to improve risk stratification, prognostication, and personalized therapeutic strategies, enabling earlier intervention, enhanced clinical decision-making, and precision medicine in critical care. In particular the transition from acute to persistent critical illness represents a pivotal phase in intensive care, marked by a shift from the initial disease insult to prolonged organ dysfunction driven by complex host responses. Early identification of patients at risk of this transition remains a major clinical challenge and opportunity.Dynamic Prescription of CRRT Ready for Prime TimeContinuous renal replacement therapy (CRRT) has evolved from a standardized supportive therapy to a platform for precision critical care. Increasing evidence suggests that fixed prescriptions fail to accommodate the dynamic physiological changes encountered during critical illness, resulting in suboptimal solute clearance, fluid management, and metabolic control. Dynamic prescription integrates evolving haemodynamic status, fluid balance, acid–base homeostasis, electrolyte disturbances, and recovery trajectories to optimize therapy delivery while minimizing complications and treatment interruptions. This paradigm supports individualized kidney support rather than protocol-driven care. Emerging decision-support systems and data-driven algorithms have the potential to transform CRRT into a responsive, patient-centred intervention, improving kidney recovery, organ support, and outcomes in critically ill patients. Adapting CRRT for patients with Electrolyte and acid-base disordersContinuous renal replacement therapy (CRRT) is uniquely positioned to provide precise correction of complex electrolyte and acid–base disturbances in critically ill patients. Beyond kidney support, modern CRRT prescriptions can be individualized to account for the severity and evolution of dysnatremia, dyskalemia, calcium disorders, and metabolic acidosis or alkalosis. Customization of dialysate and replacement fluid composition, treatment dose, buffer delivery, and regional citrate anticoagulation enables controlled correction while minimizing the risks of metabolic complications. Dynamic prescription based on serial biochemical monitoring and changing clinical physiology can be embedded into treatment protocols, facilitating safe correction of sodium, potassium, calcium, and bicarbonate abnormalities while optimizing organ support and improving outcomes in critically ill patients. Extracorporeal Therapies in Trauma, Burns and Cerebral OedemaExtracorporeal therapies (ECTs) are an important adjunct in the management of critically ill patients with severe trauma, major burns, and brain injuries. Acute kidney injury, systemic inflammation, rhabdomyolysis, and profound fluid and electrolyte disturbances frequently complicate these conditions, necessitating timely organ support. Continuous kidney replacement therapy (CKRT) provides effective management of metabolic derangements while enabling precise fluid balance in hemodynamically unstable patients. In trauma and burns, ECTs may facilitate the clearance of myoglobin in severe rhabdomyolysis, support fluid management during resuscitation, and could enable removal of damage or pathogen associated molecular patterns mediating multiorgan failure. In patients with cerebral edema, CKRT offers gradual osmotic control and minimizes intracranial pressure fluctuations compared with intermittent dialysis, making it the preferred modality when kidney replacement therapy is required. We will review current evidence, practical considerations, and emerging extracorporeal strategies, highlighting their role in improving physiological stability and supporting recovery in critically ill patients.
• 16:15

  16:30
  Multimodal individualized hemodynamic management
  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.
• 16:30

  16:45
  Utility of Lung Ultrasound, VEXUS and Bioimpedance Analysis in Volume Assessment During RRT
  Nuttha LumlertgulThailand Speaker Solution and Fluid BalanceUtility of Lung Ultrasound, VEXUS and Bioimpedance Analysis in Volume Assessment During RRTPersonalized Fluid Management with CRRT
• 16:45

  17:00
  Immune Disorders of AKI Patients Following Various Types of Injuries ?
  Thomas RimmeléFrance Speaker Managing Patients with Sepsis: Modifying the Course with ECOSImmune Disorders of AKI Patients Following Various Types of Injuries ?How Do I Use Hemadsorption in My Practice
• 17:00

  17:30
  Critical Care Nephrology: Literature Review
  Kianoush KashaniUnited States Speaker Practical Steps to Train (and Become) an AI-Era PhysicianAI in Critical Care Nephrology — State of the Art and the Path from Algorithm to BedsideCritical Care Nephrology: Literature ReviewChat GPT Applications in Critical Care Nephrology
• 17:30

  17:40
  Q & A

• 16:00

  16:05
  Symposium Introduction
  Chih-Hsien WangTaiwan Speaker

  Wen-Chien HuangTaiwan Speaker
• 16:05

  16:30
  AKI During ECMO: Is It a Consequence, a Complication, or a Modifiable Target?
  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?
• 16:30

  16:55
  Fluid Management on ECMO: When Is "Dry" Protective and When Is It Dangerous?
  Ho-Tsung Hsin Speaker Fluid Management on ECMO: When Is Dry Protective and When Is It Dangerous?
• 16:55

  17:20
  Connecting CRRT to ECMO: Circuit Configuration, Anticoagulation, and Quality Metrics.
  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
• 17:20

  17:30
  Panel Discussion

• 16:00

  16:45
  Serum cystatin C should replace serum creatinine as the primary functional biomarker for diagnosing AKI and assessing recovery.
  Chih-Jen WuTaiwan Moderator

  Nattachai SrisawatThailand Moderator Precision Sepsis-AKI — Biomarkers, AI and Phenotyping in the Asia-PacificSepsis-associated AKI in the Asia-Pacific carries a burden that global datasets underrepresent. In the SEA-AKI prospective multicentre ICU study, AKI was very common, with stage 3 reaching 28.9%, and infectious disease among the independent risk factors for AKI development. In the InSEA-RRT registry — 2,315 critically ill patients with stage 3 AKI across 24 hospitals in Southeast Asia and India — 47% died during hospitalization, with major adverse kidney events tracked to two years. These cohorts expose the limits of treating sepsis-AKI as one disease. This lecture examines how damage and stress biomarkers, machine-learning models trained on regional rather than imported data, and sub-phenotyping by trajectory and host response can move us from a single creatinine-based label toward actionable patient groups. Emphasis will be on what is deployable in resource-variable settings, where biomarker access is uneven and registry infrastructure is often the practical starting point for precision medicine.Timing of DialysisWhen to start kidney replacement therapy (KRT) in AKI remains one of the most frequent bedside decisions in critical care, and the trial evidence has settled less than it first appears. ELAIN favoured early initiation, AKIKI and IDEAL-ICU did not, STARRT-AKI showed no survival benefit from an accelerated strategy with more dialysis dependence at 90 days, and AKIKI-2 found that delaying further offered no advantage and may cause harm. This session works through illustrative cases rather than trial summaries: the patient with rising creatinine but no urgent indication, refractory hyperkalaemia or acidosis demanding immediate treatment, the fluid-overloaded patient with worsening oxygenation, and the diuretic-responsive patient in whom watchful waiting proves correct. Each case is used to separate absolute indications from the discretionary zone where trials apply. Emphasis will be on practical decision aids — urine output trajectory, furosemide stress testing, fluid balance, and organ-support burden — and on when not starting is the better decision.Acute PD vs Acute HD: Which Is the Right Choice?For AKI requiring kidney replacement therapy outside well-resourced ICUs, the practical question is which modality can be started safely tonight. Acute peritoneal dialysis (PD) needs no vascular access, anticoagulation, water treatment, or machine, but concerns persist about clearance and ultrafiltration control. Our multicentre randomized trial assigned 157 patients with AKI to lower-dosage acute PD (18–24 L/day) or intermittent hemodialysis three times weekly. Sepsis caused 68% of AKI. Twenty-eight-day mortality was 50% versus 49% (risk difference 0.6%), meeting the prespecified noninferiority margin, with comparable dialysis-free survival and seven-day fluid balance. Complications diverged rather than favoured one modality: intradialytic hypotension was more frequent with hemodialysis, hypokalemia with PD. This lecture translates these findings into practice — where lower-dosage PD is a legitimate first choice, where it is not, how to prescribe and monitor it, and how modality availability shapes AKI preparedness in resource-limited settings.

  Ying-Ying Chen Judge
• 16:50

  17:35
  For critically ill patients with AKI and severe metabolic acidosis, bicarbonate therapy should be administered routinely.
  Cheng-Chia LeeTaiwan Moderator

  Manish KaushikSingapore Moderator Patient Selection, Modality, DoseAccess, Membrane, CircuitSevere Hypernatremia and Hyperkalemia in AKI Requiring KRTPrecision Solute Control and Dynamic Dosing with CRRT

  Jui-Yi ChenTaiwan Judge

• 16:00

  16:05
  Opening Remarks
  Chia-Te LiaoTaiwan Speaker
• 16:05

  16:20
  Tolvaptan for ADPKD in Taiwan
  Tze-Wah KaoTaiwan Speaker

  Chia-Te LiaoTaiwan Moderator
• 16:20

  17:10
  New Treatments for ADPKD
  Albert OngUnited Kingdom Speaker

  Ming-Yang ChangTaiwan Moderator
• 17:10

  17:25
  Discussion
• 17:25

  17:30
  Closing Remarks

• 18:00

  18:07
  A Built-in Filtration-Fraction Calculator Improves Continuous Veno-Venous Hemofiltration Prescription Quality and Circuit Performance in Critically Ill Patients with Acute Kidney Injury
  Acute RRT Techniques
  #AKICRRT26-108
  Yu-Wei ChenTaiwan Presenter Initiating Acute PD in the ICU: What Actually Works in Practice
• 18:07

  18:14
  Personalized Survival Prediction for Patients with Acute Kidney Injury Using an Evolutionary Learning-Based Cox Model
  Research in AKI (basic, translational, clinical, trials)
  #AKICRRT26-120
  Yu-Wei ChenTaiwan Presenter Initiating Acute PD in the ICU: What Actually Works in Practice
• 18:14

  18:21
  Multidisciplinary Care for Acute Kidney Disease: Kidney Outcomes in the Randomized ISACC Trial
  Research in AKI (basic, translational, clinical, trials)
  #AKICRRT26-129
  Yu-Wei ChenTaiwan Presenter Initiating Acute PD in the ICU: What Actually Works in Practice
• 18:21

  18:28
  CORRELATION OF ALBUMIN GRADIENT AND THE REDUCTION IN THE SERUM PARAMETERS FOLLOWING SINGLE PASS ALBUMIN DIALYSIS (SPAD) IN ADULT PATIENTS WITH ACUTE AND ACUTE-ON-CHRONIC LIVER FAILURE IN A TERTIARY MEDICAL CENTER: A RETROSPECTIVE COHORT STUDY.
  Blood Purification and Organ Support
  #AKICRRT26-65
  Genecarlo LiwanagPhilippines Presenter
• 18:28

  18:35
  Inflammatory Marker Trend during oXiris Hemoadsorption in Critically Ill Children Requiring Continuous Kidney Replacement Therapy: A Case Series
  Blood Purification and Organ Support
  #AKICRRT26-112
  Ting-Yuan ChangTaiwan Presenter The Critical Initiation: Circuit Priming & Hemodynamic ManagementThis workshop addresses the critical first steps of initiating continuous kidney replacement therapy (CKRT) in pediatric patients. Topics include selecting an appropriate CKRT machine, determining hemofilter size, and designing the extracorporeal circuit. Special emphasis is placed on preventing hemodynamic instability during blood priming and circuit initiation, including calculation of the patient's circulating blood volume relative to the extracorporeal volume to avoid hypovolemic shock from excessive extracorporeal blood sequestration. Participants will learn practical decision-making frameworks for safe circuit priming strategies tailored to children of different body sizes.
• 18:35

  18:42
  Evaluation of Key Performance Indicators and Quality Measures for Continuous Renal Replacement Therapy: A Retrospective Observational Study
  Nursing Issues
  #AKICRRT26-58
  Natthamat SupakulthadasiriThailand Presenter
• 18:42

  18:49
  CKRT Hemofilter performance and filter-change thresholds: study protocol of randomized controlled trial
  Blood Purification and Organ Support
  #AKICRRT26-67
  Ka Kiu HoHong Kong, China Presenter
• 18:49

  18:56
  Early Hemoadsorption Combined with CRRT in Refractory Streptococcal Toxic Shock Syndrome: A Case Report
  Blood Purification and Organ Support
  #AKICRRT26-59
  Pham Dang HaiVietnam Presenter

• 18:00

  18:07
  Cystatin C–Creatinine eGFR for Colistin Dosing to Prevent AKI in Low-Muscle-Mass Patients: The COLD-PrevAKI RCT
  Research in AKI (basic, translational, clinical, trials)
  #AKICRRT26-130
  Win KulvichitThailand Presenter
• 18:07

  18:14
  Metformin Use and Long-Term Outcomes Following Acute Kidney Injury in Type 2 Diabetes: A Target Trial Emulation Study
  Epidemiology and Outcomes of AKI
  #AKICRRT26-100
  ZHENGHONG JIANGTaiwan Presenter
• 18:14

  18:21
  Tryptophan Attenuates Ischemia-Reperfusion Induced Acute Kidney Injury and Preserves Mitochondrial Function in a Murine Model
  Research in AKI (basic, translational, clinical, trials)
  #AKICRRT26-126
  Chung-Yi ChengTaiwan Presenter
• 18:21

  18:28
  E-FASH-Guided POCUS at Home for AKI and UTI Assessment in Hospital-at-Home Care
  Multidisciplinary
  #AKICRRT26-179
  Hung-Bin TsaiTaiwan Presenter
• 18:28

  18:35
  Detection of augmented renal clearance in traumatic brain injury patients
  Research in AKI (basic, translational, clinical, trials)
  #AKICRRT26-76
  Yuta NakamuraJapan Presenter
• 18:35

  18:42
  Kidney Targeting Delivery of Biopharmaceuticals Using Transformable Polymer
  Multidisciplinary
  #AKICRRT26-45
  Taishi HigashiJapan Presenter
• 18:42

  18:49
  KIDNEY BIOPSY CLARIFIED CHRONICITY AND PROGNOSIS IN CHRONIC ACTIVE RENAL THROMBOTIC MICROANGIOPATHY
  Multidisciplinary
  #AKICRRT26-189
  Thoi The NguyenVietnam Presenter
• 18:49

  18:56
  Case Report: Renal-Limited Thrombotic Microangiopathy Secondary to Systemic Lupus Erythematosus in the Absence of Lupus Nephritis: A Diagnostic Challenge
  Multidisciplinary
  #AKICRRT26-27
  Hoang UyenVietnam Presenter

• 18:00

  18:07
  Transportability and Deployment Readiness of an Explainable AI Model for Early Acute Kidney Injury Prediction in the Intensive Care Unit
  Research in AKI (basic, translational, clinical, trials)
  #AKICRRT26-199
  Nguyen Quoc Khanh LeTaiwan Presenter
• 18:07

  18:14
  Prediction Timing Determines Performance and Clinical Interpretability of Machine Learning Models for Acute Kidney Injury
  Research in AKI (basic, translational, clinical, trials)
  #AKICRRT26-207
  Nguyen Quoc Khanh LeTaiwan Presenter
• 18:14

  18:21
  Interpretable Machine Learning Enables Early Prediction of Acute Kidney Injury Using Only Admission-Time Variables in a Resource-Limited ICU
  Research in AKI (basic, translational, clinical, trials)
  #AKICRRT26-195
  Nadine Huyen NguyenTaiwan Presenter
• 18:21

  18:28
  Comparative Effectiveness and Safety of Bisphosphonates versus Denosumab in Non-Dialysis Stage 3-5 Chronic Kidney Disease
  Pharmacy Issues
  #AKICRRT26-113
  Jing Huan LiaoTaiwan Presenter
• 18:28

  18:35
  Sodium-Glucose Co-transporter 2 Inhibitor Use and the Differential Risk of Cardiachronic -RENAL Renal Syndrome and End-Stage Kidney Disease: A Competing-Risks Analysis in a Propensity Score-Matched Chronic Disease Cohort
  Pharmacy Issues
  #AKICRRT26-185
  Jun-Jun YehTaiwan Presenter
• 18:35

  18:42
  Plasma Proenkephalin Predicts adverse outcomes in Patients with Acute Kidney Disease
  Research in AKI (basic, translational, clinical, trials)
  #AKICRRT26-56
  Li-Chun LinTaiwan Presenter
• 18:42

  18:49
  Clinical Characteristics, Management Patterns, and Short-term Outcomes of Patients with Acute Kidney Injury in the Intensive Care Unit treated with Continuous Kidney Replacement Therapy: A single-center, retrospective cohort study.
  Research in AKI (basic, translational, clinical, trials)
  #AKICRRT26-87
  Cesar MoralesPhilippines Presenter