Worldwide Exploration of Renal Replacement Outcomes Collaborative in Kidney Disease (WE-ROCK)

Shina Menon; Kelli A Krallman; Ayse A Arikan; Dana Y Fuhrman; Stephen M Gorga; Theresa Mottes; Nicholas Ollberding; Zaccaria Ricci; Natalja L Stanski; David T Selewski; Danielle E Soranno; Michael Zappitelli; Huaiyu Zang; Katja M Gist; WE-ROCK Investigators

doi:10.1016/j.ekir.2023.05.026

Worldwide Exploration of Renal Replacement Outcomes Collaborative in Kidney Disease (WE-ROCK)

Kidney Int Rep. 2023 Jun 5;8(8):1542-1552. doi: 10.1016/j.ekir.2023.05.026. eCollection 2023 Aug.

Collaborators

WE-ROCK Investigators:
Emily Ahern¹¹, Ayse Akcan Arikan¹², Issa Alhamoud¹³, Rashid Alobaidi¹⁴, Pilar Anton-Martin¹⁵, Shanthi S Balani¹⁶, Matthew Barhight¹⁷, Abby Basalely¹⁸, Amee M Bigelow¹⁹, Gabriella Bottari²⁰, Andrea Cappoli²⁰, Eileen A Ciccia²¹, Michaela Collins²², Denise Colosimo²³, Gerard Cortina²⁴, Mihaela A Damian²⁵, Sara De la Mata Navazo²⁶, Gabrielle DeAbreu¹⁸, Akash Deep²⁷, Kathy L Ding²⁸, Kristin J Dolan¹², Sarah N Fernandez Lafever²⁶, Dana Y Fuhrman²⁹, Ben Gelbart³⁰, Katja M Gist²², Stephen M Gorga³¹, Francesco Guzzi³², Isabella Guzzo²⁰, Taiki Haga³³, Elizabeth Harvey³⁴, Denise C Hasson³⁵, Taylor Hill-Horowitz¹⁸, Haleigh Inthavong¹², Catherine Joseph¹², Ahmad Kaddourah³⁶, Aadil Kakajiwala³⁷, Aaron D Kessel¹⁸, Sarah Korn³⁸, Kelli A Krallman²², David M Kwiatkowski³⁹, Jasmine Lee³⁴, Laurance Lequier¹⁴, Tina Madani Kia¹⁴, Kenneth E Mah²⁵, Eleonora Marinari²⁰, Susan D Martin⁴⁰, Shina Menon⁴¹, Tahagod H Mohamed¹⁹, Catherine Morgan¹⁴, Theresa A Mottes¹⁷, Melissa A Muff-Luett⁴², Siva Namachivayam³⁰, Tara M Neumayr²¹, Jennifer Nhan Md³⁷, Abigail O'Rourke¹⁸, Nicholas J Ollberding²², Matthew G Pinto⁴³, Dua Qutob³⁶, Valeria Raggi²⁰, Stephanie Reynaud⁴⁴, Zaccaria Ricci²³, Zachary A Rumlow¹³, María J Santiago Lozano²⁶, Emily See³⁰, David T Selewski⁴⁵, Carmela Serpe²⁰, Alyssa Serratore³⁰, Ananya Shah²⁸, Weiwen V Shih^{11

28}, H Stella Shin⁴⁶, Cara L Slagle²², Sonia Solomon⁴³, Danielle E Soranno⁴⁷, Rachana Srivastava⁴⁸, Natalja L Stanski²², Michelle C Starr⁴⁷, Erin K Stenson^{11

28}, Amy E Strong¹³, Susan A Taylor²⁷, Sameer V Thadani¹², Amanda M Uber⁴², Brynna Van Wyk¹³, Tennille N Webb⁴⁹, Huaiyu Zang²², Emily E Zangla¹⁶, Michael Zappitelli³⁴

Affiliations

¹ Department of Pediatrics, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Washington, USA.
² Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
³ Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA.
⁴ Department of Pediatrics, Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
⁵ Department of Pediatrics, University of Michigan Medical School, C.S. Mott Children's Hospital, Ann Arbor, Michigan, USA.
⁶ Department of Pediatrics, Anne and Robert Lurie Children's Hospital, Northwestern University School of Medicine, Chicago, Illinois, USA.
⁷ Department of Pediatrics, Meyer University Hospital, University of Florence, Florence, Italy.
⁸ Department of Pediatrics, Children's Hospital of South Carolina, Medical University of South Carolina, Charleston, South Carolina, USA.
⁹ Department of Pediatrics and Bioengineering, Indiana University, Riley Children's Hospital, Indianapolis, Indiana.
¹⁰ Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
¹¹ Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, CO, USA.
¹² Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA.
¹³ University of Iowa Stead Family Children's Hospital, Carver College of Medicine, Iowa City, IA, USA.
¹⁴ Univeristy of Alberta, Edmonton, Canada.
¹⁵ Le Bonheur Children's Hospital, Memphis, TN, USA.
¹⁶ University of Minnesota, Minneapolis, MN, USA.
¹⁷ Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.
¹⁸ Cohen Children's Medical Center, Zucker School of Medicine, New Hyde Park, NY, USA.
¹⁹ Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH, USA.
²⁰ Bambino Gesù Children Hospital, IRCCS, Rome, Italy.
²¹ Washington University School of Medicine, St. Louis Children's Hospital, St. Louis, MO, USA.
²² Cincinnati Children's Hospital Medical Center; University of Cincinnati College of Medicine, Cincinnati, OH, USA.
²³ Meyer Children's Hospital, IRCCS, Florence, Italy.
²⁴ Medical University of Innsbruck, Innsbruck, Austria.
²⁵ Stanford University School of Medicine, Palo Alto, CA, USA.
²⁶ Gregorio Marañón University Hospital; School of Medicine, Madrid, Spain.
²⁷ King's College Hospital, London, England.
²⁸ University of Colorado, School of Medicine, Aurora, CO, USA.
²⁹ University of Pittsburgh Medical Center Children's Hospital of Pittsburgh, Pittsburgh, PA, USA.
³⁰ Royal Children's Hospital, University of Melbourne, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
³¹ University of Michigan Medical School, C.S. Mott Children's Hospital, Ann Arbor, MI, USA.
³² Santo Stefano Hospital, Prato, Italy.
³³ Osaka City General Hospital, Osaka, Japan.
³⁴ Hospital for Sick Children, Toronto, Ontario, Canada.
³⁵ NYU Langone Health, Hassenfeld Children's Hospital, New York, NY, USA.
³⁶ Sidra Medicine and Weil Cornel Medicine, Qatar, Doha, Qatar.
³⁷ Children's National Hospital, Washington, DC, USA.
³⁸ Westchester Medical Center, Westchester, NY, USA.
³⁹ Lucile Packard Children's Hospital, Palo Alto, CA, USA.
⁴⁰ Golisano Children's Hospital at University of Rochester Medical Center, Rochester, NY, USA.
⁴¹ Seattle Children's Hospital, University of Washington, Seattle, WA, USA.
⁴² University of Nebraska Medical Center, Children's Hospital & Medical Center, Omaha, NE, USA.
⁴³ Maria Fareri Children's Hospital at Westchester Medical Center, Valhalla, NY, USA.
⁴⁴ Hopital Bicetre, APHP Université Paris-Saclay, Kremlin-Bicetre, Val de Marne, France.
⁴⁵ Medical University of South Carolina, Charleston, SC, USA.
⁴⁶ Children's Healthcare of Atlanta, Emory University, Atlanta, GA, USA.
⁴⁷ Indiana University School of Medicine, Riley Hospital for Children, Indianapolis, IN, USA.
⁴⁸ Mattel Children's Hospital at UCLA, Los Angeles, Ca, USA.
⁴⁹ Children's of Alabama/University of Alabama at Birmingham, Birmingham, AL, USA.

Abstract

Introduction: Continuous renal replacement therapy (CRRT) is used for the symptomatic management of acute kidney injury (AKI) and fluid overload (FO). Contemporary reports on pediatric CRRT are small and single center in design. Large international studies evaluating CRRT practice and outcomes are lacking. Herein, we describe the design of a multinational collaborative.

Methods: The Worldwide Exploration of Renal Replacement Outcomes Collaborative in Kidney Disease (WE-ROCK) is an international collaborative of pediatric specialists whose mission is to improve short- and long-term outcomes of children treated with CRRT. The aims of this multicenter retrospective study are to describe the epidemiology, liberation patterns, association of fluid balance and timing of CRRT initiation, and CRRT prescription with outcomes.

Results: We included children (n = 996, 0-25 years) admitted to an intensive care unit (ICU) and treated with CRRT for AKI or FO at 32 centers (in 7 countries) from 2018 to 2021. Demographics and clinical characteristics before CRRT initiation, during the first 7 days of both CRRT, and liberation were collected. Outcomes include the following: (i) major adverse kidney events at 90 days (mortality, dialysis dependence, and persistent kidney dysfunction), and (ii) functional outcomes (functional stats scale).

Conclusion: The retrospective WE-ROCK study represents the largest international registry of children receiving CRRT for AKI or FO. It will serve as a broad and invaluable resource for the field of pediatric critical care nephrology that will improve our understanding of practice heterogeneity and the association of CRRT with clinical and patient-centered outcomes. This will generate preliminary data for future interventional trials in this area.

Keywords: WE-ROCK; acute kidney injury; continuous renal replacement therapy; database; fluid overload; pediatric.

Worldwide Exploration of Renal Replacement Outcomes Collaborative in Kidney Disease (WE-ROCK)

Authors

Collaborators

Affiliations

Abstract

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