Shih-Chi Ku

18th September 2026 Friday

Time Session
16:00
17:00
(Vantive)
Ashita TolwaniUnited States Moderator The ABC of the CRRT PrescriptionPrescribing continuous renal replacement therapy requires an understanding of how modality, blood flow, treatment dose, replacement-fluid delivery, and circuit factors influence therapy delivery. This presentation will provide a practical framework for developing and evaluating a CRRT prescription, including the principles of diffusive and convective clearance, prescribed versus delivered dose, and the impact of replacement-fluid location and treatment interruptions. Clinical examples will highlight common prescribing challenges and demonstrate how CRRT settings can be adjusted to meet changing patient needs while maintaining effective and safe therapy.AnticoagulationEffective anticoagulation is essential to maintain circuit patency, minimize blood loss, and ensure delivery of the prescribed CRRT dose. This presentation will review the principles guiding anticoagulant selection during CRRT, including the relative roles of regional citrate anticoagulation, unfractionated heparin, and alternative agents. Particular emphasis will be placed on balancing circuit longevity with patient safety, recognizing patients at increased risk for bleeding or citrate intolerance, and monitoring for metabolic and anticoagulation-related complications. Dysnatremia and Acid-Base DisordersContinuous renal replacement therapy can be adapted to safely manage severe sodium and acid–base disturbances. This presentation will review a practical approach to modifying the CRRT prescription based on the patient’s serum sodium, acid–base status, and desired rate of correction. Emphasis will be placed on anticipating how CRRT solutions and treatment settings influence biochemical changes and on avoiding overly rapid correction or treatment-related complications. Clinical examples will illustrate key principles for individualized therapy.Managing Patients With Combined Kidney and Liver Failure
Shih-Chi KuTaiwan Moderator
Room 101AB
17:10
18:00
  • 守護腎臟機能:高品質 CRRT 提升恢復率並減輕長期透析負擔之臨床探討
    Chih-Hsiang ChangTaiwan Speaker 重塑生命韌性:從 ICU 治療到回歸社會的康復之路急性腎損傷的照護目標不應止於 ICU 存活或成功脫離連續性腎臟替代治療(CRRT),而應延伸至腎功能恢復、身體功能重建與重返家庭及社會。高品質 CRRT 是此一照護路徑的起點,包括適切的治療時機與劑量、血流動力學穩定、液體管理、抗凝策略及治療中斷監測,以降低治療相關傷害並提升腎臟恢復機會。然而,出院後追蹤中斷、急性腎損傷病程辨識不足及跨專業資訊斷裂,仍使患者面臨慢性腎臟病、長期透析、再住院及功能衰退的風險。因此,台灣應建立從 ICU 延伸至社區的急性腎損傷整合照護政策:以標準化品質指標確保 CRRT 治療品質;透過電子警示、風險分層與跨院資料串接辨識高風險患者;並於出院後整合腎臟功能、藥物、營養、復健及病人報告結果的追蹤。最終政策成效不僅應評估死亡率與透析依賴,更應納入腎功能恢復、再住院、生活品質及重返社會,將急性期救命治療轉化為可衡量、可持續的生命韌性照護。
  • 從血液淨化邁向多器官支持療法,以品質指標、治療成效監測與真實世界資料最佳化重症預後之臨床實踐
    Yen-Ta HuangTaiwan Speaker From Guidelines to Bayesian Trials: How Should We Interpret Polymyxin B Hemoadsorption in Sepsis?Polymyxin B hemoadsorption has occupied an unusually contested place in sepsis care, and the way authoritative bodies describe it has shifted over time. This talk traces that evolution—from the 2020 Taiwan AKI consensus through the 2021 and 2026 Surviving Sepsis Campaign guidelines—and uses the changing recommendations as a lens on the methodological debates that underlie them. From an evidence-based medicine standpoint, the controversy is less about the device than about how we generate and grade evidence. I will first examine the frequentist evidence base, including our network meta-analysis of blood purification therapies for severe infection and sepsis/septic shock published in Critical Care Medicine. I will outline what a network meta-analysis adds—coherent ranking across multiple modalities, indirect comparison, and explicit quantification of heterogeneity—while being candid about its limitations, including reliance on the transitivity assumption, sparse networks, and the fragility of mortality estimates pooled from heterogeneous trials. I will then turn to the recently reported TIGRIS trial, which used a Bayesian, enrichment-based phase 3 design with prespecified borrowing from the EUPHRATES treatable cohort. I will highlight the strengths of the Bayesian presentation—direct posterior probabilities of benefit, transparent incorporation of prior evidence, and efficiency in a rare, mechanistically defined phenotype—alongside the cautions it demands: sensitivity to prior choice, the open-label design, and the gap between a high posterior probability and a confirmed effect. Bringing these strands together, the talk offers a multifaceted, methodology-driven reading of polymyxin B hemoadsorption in sepsis, and a transferable framework for clinicians facing the increasingly common situation in which guidelines, frequentist syntheses, and Bayesian trials appear to diverge.從治療執行到品質治理:連結式重症腎臟照護與資料驅動決策
  • Lui ForniUnited Kingdom Speaker Sepsis Associated AKIBicarbonate in AKI: Use and MisuseAdapting CRRT for Patients with Electrolyte and ACID-Base Disorders
    Shih-Chi KuTaiwan Moderator
  • 「急性腎損傷照護數位提升共同宣言」 持續優化器官支持治療與連續性照護品質,攜手推動台灣腎臟與重症醫療體系之穩健與長遠發展
Room 101AB

19th September 2026 Saturday

Time Session
10:45
12:30
Chi-yuan HsuUnited States Moderator Targeting Persistent AKI and Promoting RecoveryDoes Mild to Moderate AKI Actually Cause CKD?
Shih-Chi KuTaiwan Moderator
  • Lui ForniUnited Kingdom Speaker Sepsis Associated AKIBicarbonate in AKI: Use and MisuseAdapting CRRT for Patients with Electrolyte and ACID-Base Disorders
  • 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)
  • 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.
  • 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
Room 101