Related Experiment Video
Updated: Jun 15, 2025
Digital Home-Monitoring of Patients after Kidney Transplantation: The MACCS Platform
Published on: April 12, 2021
Kidney Health Monitoring in Neonatal Intensive Care Unit Graduates: A Modified Delphi Consensus Statement
Michelle C Starr1,2, Matthew W Harer3, Heidi J Steflik4
1Division of Pediatric Nephrology, Department of Pediatrics, Indiana University School of Medicine, Indianapolis.
Insights
Neonatal intensive care unit (NICU) graduates face risks for chronic kidney disease (CKD). New recommendations guide post-discharge care, focusing on risk assessment and monitoring for preterm infants, those with acute kidney injury (AKI), and critical cardiac conditions.
Area of Science:
- Neonatal Nephrology
- Pediatric Nephrology
- Public Health
Background:
- Kidney disease is a significant concern for infants in the neonatal intensive care unit (NICU).
- There is a lack of evidence-based guidelines for managing chronic kidney disease (CKD) risk in infants after NICU discharge.
- Infants discharged from the NICU are at risk for developing CKD.
Purpose of the Study:
- To establish recommendations for risk stratification and kidney health monitoring in infants following NICU discharge.
- To provide guidance for clinicians caring for high-risk infants after they leave the NICU.
Main Methods:
- A consensus workshop involving 51 neonatal nephrology experts was convened.
- Modified Delphi processes were used to derive consensus recommendations.
- Focus was placed on three high-risk infant groups: preterm, those with acute kidney injury (AKI), and those with critical cardiac disease.
Main Results:
- Ten consensus recommendations were developed for post-NICU kidney health care.
- Key suggestions include risk stratification at discharge, education for families and clinicians, and outpatient blood pressure assessment.
- Gaps in knowledge and priorities for future research were identified.
Conclusions:
- Preterm infants, infants with AKI, and infants with critical cardiac disease represent high-risk populations for CKD.
- Recommendations emphasize discharge risk assessment, education, and tailored kidney health monitoring.
- Further research is needed to refine risk stratification, detect early dysfunction, and develop interventions for long-term kidney health.
Importance:
Kidney disease is common in infants admitted to the neonatal intensive care unit (NICU). Despite the risk of chronic kidney disease (CKD) in infants discharged from the NICU, neither evidence- nor expert-based recommendations exist to guide clinical care after discharge.
Objective:
To develop recommendations for risk stratification and kidney health monitoring among infants after discharge from the NICU.
Evidence Review:
At the National Institute of Health-supported Consensus Workshop to Address Kidney Health in Neonatal Intensive Care Unit Graduates meeting conducted in February 2024, a panel of 51 neonatal nephrology experts focused on 3 at-risk groups: (1) preterm infants, (2) critically ill infants with acute kidney injury (AKI), and (3) infants with critical cardiac disease. Using established modified Delphi processes, workgroups derived consensus recommendations.
Findings:
In this modified Delphi consensus statement, the panel developed 10 consensus recommendations, identified gaps in knowledge, and prioritized areas of future research. Principal suggestions include risk stratification at time of hospital discharge, family and clinician education and counseling for subsequent kidney health follow-up, and blood pressure assessment as part of outpatient care.
Conclusions And Relevance:
Preterm infants, critically ill infants with AKI, and infants with critical cardiac disease are at increased risk of CKD. We recommend (1) risk assessment at the time of discharge, (2) clinician and family education, and (3) kidney health assessments based on the degree of risk. Future work should focus on improved risk stratification, identification of early kidney dysfunction, and development of interventions to improve long-term kidney health.
More Related Videos
10:38Observational Study Protocol for Repeated Clinical Examination and Critical Care Ultrasonography Within the Simple Intensive Care Studies
Published on: January 16, 2019
19:15Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
