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. 2025 Sep;40(9):2993-3004.
doi: 10.1007/s00467-025-06757-7. Epub 2025 Apr 15.

Expanded discussion of kidney health monitoring for critically ill term and late preterm infants after acute kidney injury: a report from the Neonatal Kidney Health Consensus Workshop

Kim T Vuong #  1   2 , Brianna M Liberio #  3 , Samantha R Schwartz #  4 , Shina Menon  5 , Tahagod H Mohamed  6 , Danielle E Soranno  7 , Kara Short Johnson  8 , Jennifer G Jetton  9 , Kyle A Merrill  10 , Mina Hanna  11 , Michelle C Starr  7   12 , David T Selewski  13 , Heidi J Steflik  14 ; Neonatal Kidney Health Consensus Workshop
Collaborators, Affiliations

Expanded discussion of kidney health monitoring for critically ill term and late preterm infants after acute kidney injury: a report from the Neonatal Kidney Health Consensus Workshop

Kim T Vuong et al. Pediatr Nephrol. 2025 Sep.

Abstract

Background: Acute kidney injury (AKI) is common in the neonatal intensive care unit (NICU) and is associated with increased morbidity and mortality. Mounting evidence suggests infants with AKI in the NICU have higher risks of long-term kidney dysfunction, such as chronic kidney disease. However, guidelines for outpatient kidney-focused follow-up practices are lacking.

Methods: As part of the National Institutes of Health-sponsored Consensus Workshop to Address Kidney Health in Neonatal Intensive Care Unit Graduates, a multidisciplinary workgroup within the US performed an in-depth review of the medical literature on term and late preterm (i.e. ≥ 34 weeks gestation) neonates admitted to the NICU with AKI to inform consensus recommendations for outpatient kidney health monitoring for high-risk and at-risk infants.

Results: In this modified Delphi consensus statement, the workgroup developed three consensus recommendations and identified priority research gaps and opportunities for future study. Specific recommendations include completing a NICU discharge kidney health evaluation followed by a comprehensive kidney health assessment six months after discharge for high-risk infants and at two years of age for high-risk and at-risk infants.

Conclusions: Critically ill term and late preterm infants with AKI have an increased risk of long-term kidney dysfunction and merit evaluation at NICU discharge with subsequent comprehensive kidney health assessments based on risk factors. Current research gaps and opportunities for improved care include identifying optimal pre-discharge planning approaches, examining the impacts of different etiologies and severity of AKI on long-term kidney and overall health, exploring modification to current AKI diagnosis standards, and development of high-yield educational tools for families and providers.

Keywords: Acute kidney injury; Late preterm; NICU discharge; Neonatal nephrology; Term.

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Conflict of interest statement

Declarations. Disclaimer: While some content contained in this manuscript has been previously published, the focus of this manuscript is to elaborate on this specific subgroup of critically ill infants with AKI (born ≥ 34 weeks gestation) in greater detail [15]. Competing interests: Drs. Jetton, Menon, Selewski, Starr, and Steflik reported serving on the board of the Neonatal Kidney Collaborative. Dr. Starr reporting receiving funding from the National Institutes of Health (NIH) and the Gerber Foundation outside the submitted work. Dr. Steflik reported receiving grants from Baxter outside the submitted work and ending December 2023. Dr. Menon reported receiving grants from the Gerber Foundation outside the submitted work. No other disclosures were reported.

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