Multidisciplinary neonatal acute kidney injury provider perceptions and practice patterns.

Area of Science:

• Neonatology
• Pediatric Nephrology
• Critical Care Medicine

Background:

• Neonatal acute kidney injury (AKI) was underappreciated in a 2017 survey, with significant variation in diagnosis and management.
• An updated international survey assessed changes in perceptions and practices among pediatric subspecialists regarding neonatal AKI.

Purpose of the Study:

• To determine if perceptions and practices related to neonatal AKI have evolved among international pediatric subspecialists.
• To identify current trends in AKI detection, monitoring, and follow-up protocols.

Main Methods:

• A 50-question electronic survey on AKI was distributed to neonatologists, pediatric nephrologists, pediatric intensivists, and advanced practice providers (APPs).
• Responses were collected from March to May 2024 and compared across subspecialties and country economic classifications.

Main Results:

• 676 responses were received from 68 countries, with the modified KDIGO criteria used most frequently for AKI diagnosis (46.1%).
• Most respondents lacked specific AKI identification (75.8%) or monitoring protocols (75%).
• Creatinine surveillance increased for aminoglycoside and indomethacin use, and routine electrolyte panels improved creatinine access; pediatric nephrologist availability also increased.

Conclusions:

• Perceptions and practices for neonatal AKI continue to differ across subspecialties.
• Improvements in serum creatinine monitoring access and nephrology consultation availability were observed.
• Standardized approaches for AKI detection, management, and follow-up are lacking, highlighting the need for provider education and guideline development.