Standardizing Care in Pediatric Continuous Kidney Replacement Therapy—Can We Reach Consensus Without Adequate Evidence?

Continuous kidney replacement therapy (CKRT) is the predominant extracorporeal support for management of acute kidney injury, fluid overload, and metabolic derangements. Daverio and colleagues 1 surveyed professionals from pediatric intensive care units (PICUs) in 20 countries across Europe.Thestudycoveredvariousdomainsofcenterandrespondentcharacteristics,organizational aspects for education and training, CKRT duration, vascular access, approach to CKRT termination, anticoagulation, and fluid-removal strategies. Only a single response from each center was captured, with an impressive 76% response rate. Not surprisingly, there was substantial heterogeneity in practice across all domains of assessment. Perhaps the true testament to the high response rate was how this survey was disseminated, which leveraged an official organization: the European Society of Paediatric and Neonatal Intensive Care (ESPNIC). Members of ESPNIC might be more likely to complete a survey when it is disseminated by an official organization, which potentially aids in amplifying importance. There are