The Center for Acute Care Nephrology (CACN) is committed to developing and standardizing optimal care – and realizing the optimal outcomes – for children and adults with or at risk for acute kidney injury. Through many collaborations, nationally and internationally, the CACN conducts research projects that explore identification, treatment and prevention of acute kidney injury and renal failure. At Cincinnati Children’s, the CACN is working to change the outcomes together through various partnerships, including:

Collaboration with Heart Institute at Cincinnati Children’s Hospital

  • Demonstrating the presence of kidney damage biomarkers 5 to 8 years after AKI in children who developed AKI after cardiac surgery
  • A first-of-its-kind study showed peritoneal dialysis was superior to IV furosemide as a fluid balance control therapy for infants recovering from cardiac bypass surgery
  • Identification of novel kidney damage biomarkers in patients with chronic cardiac disease associated with dilated cardiomyopathy or Fontan physiology

Collaboration with Intensive Care Unit at Cincinnati Children’s Hospital

  • Conducting studies using the Renal Angina Index to identify patients early and in real-time who are at-risk for developing severe AKI in the ICU
  • Integrating the Renal Angina Index to automatically and prospectively use validated urinary AKI biomarkers to direct early interventions to prevent or mitigate worsening AKI in critically ill children with multi-organ dysfunction syndrome
  • Developing a standardized clinical definition of diuretic responsiveness using a pediatric calibrated “furosemide stress test” to guide fluid management in critically ill children with, or at-risk for AKI

Collaboration with the James M. Anderson Center for Health Care Excellence at Cincinnati Children's Hospital

  • Identifying hospitalized patient at risk for AKI from medications that can be toxic to the kidney through the Nephrotoxic Injury Negated by Just in time Action (NINJA) program. This hospital wide effort was the first to use the electronic health record to identify at risk patients, allowing the pharmacy and nephrology departments to assist primary care teams to reduce nephrotoxic medication AKI rates and severity, and is now demonstrating similar successful outcomes at 14 other pediatric hospitals
  • Designing a systematic process for identifying and following patients that have developed AKI while in the hospital, following these patients by a designated AKI team in the outpatient setting to assess for development of chronic kidney disease

International and National Collaborative Projects

  • Coordinated the largest study of AKI epidemiology in children, the Assessment of Worldwide AKI, Renal angina and Epidemiology (AWARE) project from 32 centers in 9 countries on 4 continents. Over 5,000 were enrolled in this groundbreaking study
  • Coordinated the Nephrotoxic Injury Negated by Just-in-time Action (NINJA) collaborative to reduce nephrotoxic medication associated AKI at 14 hospitals in the US. The NINJA project has also been accepted for dissemination to the 140 pediatric hospital Solutions for Patient Safety collaborative
  • Coordinating both the Baxter HF20™ and Cytopheryx Selective Cytopheretic Device™ multi-center device evaluation studies for critically ill children who require continuous replacement therapy as part of standard of care
  • Planning to coordinate a US multi-center device evaluation/registry study for a neonatal specific CRRT machine, the Cardio-Renal PEDIatric Emergency (CARPEDIEM) platform

Contact Us

For more information regarding ongoing or upcoming research in the CACN, contact:

Kelli Krallman, RN, BSN, MS, CCRC
Research Nurse
513-636-4837

Cassie Kirby, BA, CCRP
Clinical Research Coordinator
513-803-5332

Cincinnati Children's Hospital Medical Center
Division of Nephrology and Hypertension
3333 Burnet Avenue
MLC 7022
Cincinnati, OH 45229-3039