Kianoush Kashani

• 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

• 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
• 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
• Panel Discussion

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

  Chin-Chung TsengTaiwan Speaker
• 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.
• 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.
• 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
• 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.
• 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.
• Chair's Synthesis and Take-Home Points
  Chia-Chao WuTaiwan Speaker

  Chin-Chung TsengTaiwan Speaker

• 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.
• 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.
• 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
• 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
• 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
• Q & A

• Chat GPT Applications in Critical Care Nephrology
  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
• Fluid Balance Reimagined: Hemodynamic Monitoring and Ultrafiltration Precision
  Ravindra MehtaUnited States Speaker
• Precision Volume Management in CRRT: Insights from Bioimpedance and Biomarkers
  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.
• Dynamic Prescription of CRRT: Ready for Prime Time?
  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.
• Bicarbonate in AKI: Use and Misuse
  Lui ForniUnited Kingdom Speaker Sepsis Associated AKIBicarbonate in AKI: Use and MisuseAdapting CRRT for Patients with Electrolyte and ACID-Base Disorders
• De-escalating and Transitioning RRT: Best Practices
  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
• Q & A