Consensus Workshop to Address Kidney Health in High-Risk Neonatal Intensive Care Unit Graduates

Indiana University Indianapolis, Indianapolis IN

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Abstract

Chronic kidney disease (CKD) is common in neonates who require care in the Neonatal Intensive Care Unit (NICU), particularly in premature neonates, critically ill neonates, and those with congenital heart disease. Studies of long-term kidney function in children born prematurely show a threefold increase in CKD by adolescence and into adulthood. The burden of CKD will continue to increase as more extremely preterm neonates survive into adulthood and the threshold of viability continues to decrease beyond 22 weeks’ gestation. Despite the known CKD risk for neonates discharged from the NICU, no current recommendations outline who should be monitored for CKD, when they should be monitored, or what types of testing should be performed for kidney health monitoring. Furthermore, there is a gap in our understanding of the necessary next steps and opportunities in neonatal nephrology research and clinical care, which contributes to a lack of momentum in the neonatal nephrology community. To fill key these knowledge gaps, we propose the “Consensus Workshop to Address Kidney Health in High-Risk Neonatal Intensive Care Unit Graduates” with the following aims: 1) To develop expert-based guidance on kidney health monitoring after NICU discharge for three high-risk neonatal groups, 2) Identify gaps in neonatal nephrology research and clinical care, focusing on kidney health and CKD after NICU discharge, and 3) Develop working groups to begin to close these gaps in neonatal nephrology, focusing on kidney health and CKD after NICU discharge. Successful completion of this Workshop will result in the development of recommendations to assist clinicians in determining who, when, and how to evaluate kidney health in NICU graduates. These recommendations will not only allow for improvements in clinical care, but they will also help improve how we perform research. We will also identify research and clinical care priorities in neonatal nephrology, focusing on kidney health and CKD risk in NICU graduates. Finally, we will develop Collaborative Research Groups to build upon the prioritization areas in neonatal nephrology that are identified during the Workshop, and allow for conversations on how to address these gaps. The end product will be the establishment of research infrastructure, which will set the stage for grant submission to NIH. The work that will be accomplished during the workshop is essential to future research through NIH as pragmatic clinical studies and multicenter collaborative work requires a shared understanding of best practices when it comes to kidney health monitoring. This Workshop will bring together a diverse and representative group of pediatric and adult nephrologists, neonatologists, cardiologists, intensivists, pediatricians, health service researchers, patients and families, and advocacy experts to accomplish the above aims. Furthermore, by involving trainees actively in the development of follow-up guidelines, identification of research and clinical care gaps, and formation of collaborative working groups, we strive to further develop the research pipeline in the neonatal nephrology field.