Okay, everyone, we really are ecstatic that you've stuck around and really amazing talks by all of our speakers. I can say that I think we picked the right ones. I certainly learned a lot. We tried to answer all of your questions in the chat and in the boxes just in the interest of time and knowing that we're a little bit over time. I actually just wanted to ask one question of our panelists and if anybody wanted to take an answer on this. We've heard a lot about the different aspects of kidney injury, fluid, nutrition, medications, teamwork, integration of markers, etc. Are we looking at the right endpoints? What makes sense? I mean, everyone, you know, in the world of sepsis, everyone looks at death as the endpoint. Is that the right one? What should we be looking at for AKI? I'll offer that I think the one thing that is not as well studied, particularly because it's often in critically ill patients, is we have very few patient reported endpoints are really truly patient centered. I think we talk a lot about mortality and length of stay and mechanical ventilation duration and how much volume can take off and what our drug levels are and all of those things. But when it comes to it, I think asking patients what they want and hearing from them is much more important as it pertains to whether you're bound to a dialysis machine for the rest of your life or you are doomed to chronic kidney disease, or you have to dramatically alter your diet or whatever it happens to be. I think patient reported outcomes is a major void in the literature outside of epidemiologic data saying AKI patients have worse quality of life. And I think there are systems barriers to that. In particular, I think PROs are not routinely measured on patients and healthcare systems very readily. And it's not as natural to kind of capture. But I think if we were to describe what actually is probably important, it's probably stuff from the perspective of the patient. I would definitely agree with that. And I'm excited. It sounds like there is some work people are doing in that space for the first time. And we have so much to learn in that, both in adults and kids. So uncommonly, I think as a pediatrician, we don't ask our pediatric patients in terms of their needs around receiving renal replacement therapy and their outcomes that they would desire. I think also to add from a measurement kind of quantitative standpoint, I think clearly the speakers today have, you know, we aren't allowing creatinine to do what creatinine does. We're expecting more from it, as Raj beautifully put. But that is our endpoint now that we look at and study, certainly with the make outcome. And so I think measures in particular in the pediatric population where they hopefully have a long life after the AKI, I definitely agree that mortality not being an outcome, but, you know, more measures of kidney health, getting that kidney reserve, getting that biomarkers in that space in terms of documenting and proving true recovery or effect from therapies as we get to that. Yeah. Yeah. Natalia, Michael, anything you want to add to our output of AKI? No, I think I come at it from a similar perspective as Dana being a pediatric provider, that I think we're lucky in that fewer of our patients die as a consequence of a lot of what happens to them in the ICU. But their quality of life and subsequent disease burden after their ICU stay, I think are endpoints that need to be looked at more closely and how to predict who those patients are going to be so we can make sure that they're tied into the appropriate resources when they leave the ICU, because most of them do, thankfully. And so I think that that's a relatively understudied area that really needs more work to be done. Yeah. Yeah. I would say as we finish this master class that the big take-home I'm hoping that people will take from this is get out there and talk about it. The public awareness is really, really poor, but the awareness in the hospital outside of the bully pulpit of critical care people and nephrologists and people who work in those domains is also quite poor. And the more we learn about this, the more we realize we need to put attention on this. And people like all of you who contribute your time and your energy and all your brains to this are the people who lead the work we need to do. But all of you who are out there in the audience and watching this, get out there and talk to people about this and be involved in our work, because only together can we make a real big difference.

acute kidney injury

endpoints

patient-centered outcomes

kidney health

public awareness