Journal article
Kidney Health Monitoring in Neonatal Intensive Care Unit Graduates: A Modified Delphi Consensus Statement
JAMA network open, Vol.7(9), e2435043
09/03/2024
DOI: 10.1001/jamanetworkopen.2024.35043
PMCID: PMC12163980
PMID: 39269711
Abstract
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.
Details
- Title: Subtitle
- Kidney Health Monitoring in Neonatal Intensive Care Unit Graduates: A Modified Delphi Consensus Statement
- Creators
- Michelle C. Starr - Indiana UniversityMatthew W. Harer - University of Wisconsin–MadisonHeidi J. Steflik - Medical University of South CarolinaStephen Gorga - Michigan MedicineNamasivayam Ambalavanan - University of Alabama at BirminghamTara M. Beck - Children's Hospital of PittsburghPaulomi M. Chaudhry - Indiana UniversityJennifer L. Chmielewski - Indiana UniversityMarissa J. Defreitas - University of Miami HospitalDana Y. Fuhrman - Children's Hospital of PittsburghMina Hanna - University of KentuckyCatherine Joseph - Texas Children's HospitalDavid M. Kwiatkowski - Lucile Packard Children's HospitalCatherine D. Krawczeski - Nationwide Children's HospitalBrianna M. Liberio - Indiana UniversityShina Menon - Stanford UniversityTahagod H. Mohamed - Nationwide Children's HospitalJennifer A. Rumpel - University of Arkansas for Medical SciencesKeia R. Sanderson - University of North Carolina at Chapel HillMeredith P. Schuh - Cincinnati Children's Hospital Medical CenterJeffrey L. Segar - Medical College of WisconsinCara L. Slagle - Indiana UniversityDanielle E. Soranno - Indiana UniversityKim T. Vuong - Texas Children's HospitalJennifer R. Charlton - University of VirginiaKatja M. Gist - Cincinnati Children's Hospital Medical CenterDavid J. Askenazi - University of Alabama at BirminghamDavid T. Selewski - Medical University of South CarolinaCarolyn L. Abitbol - for the Neonatal Kidney Health Consensus WorkshopKaashif A. Ahmad - for the Neonatal Kidney Health Consensus WorkshopO.N. Ray Bignall - for the Neonatal Kidney Health Consensus WorkshopPaige E. Condit - for the Neonatal Kidney Health Consensus WorkshopAmanda B. Deford - for the Neonatal Kidney Health Consensus WorkshopAlex Feeney - for the Neonatal Kidney Health Consensus WorkshopMatthew C. Gillen - for the Neonatal Kidney Health Consensus WorkshopRonnie Guillet - for the Neonatal Kidney Health Consensus WorkshopJaya S. Isaac - for the Neonatal Kidney Health Consensus WorkshopCaroline V. Jackson - for the Neonatal Kidney Health Consensus WorkshopJennifer G. Jetton - University of VirginiaMarciana L. Laster - for the Neonatal Kidney Health Consensus WorkshopKathryn J. Lowe - for the Neonatal Kidney Health Consensus WorkshopMorgan E. Marcuccilli - for the Neonatal Kidney Health Consensus WorkshopKyle A. Merrill - for the Neonatal Kidney Health Consensus WorkshopEmily A. Niemyjski - for the Neonatal Kidney Health Consensus WorkshopEvelyn Obregon - for the Neonatal Kidney Health Consensus WorkshopErin R. Rademacher - for the Neonatal Kidney Health Consensus WorkshopEvan A. Rajadhyaksha - for the Neonatal Kidney Health Consensus WorkshopKimberly J. Reidy - for the Neonatal Kidney Health Consensus WorkshopSamantha R. Schwartz - for the Neonatal Kidney Health Consensus WorkshopEmily K. Scott - for the Neonatal Kidney Health Consensus WorkshopKara C. Short - for the Neonatal Kidney Health Consensus WorkshopChristine N. Stoops - for the Neonatal Kidney Health Consensus WorkshopNamrata Todukar - for the Neonatal Kidney Health Consensus WorkshopNeonatal Kidney Health Consensus Workshop
- Resource Type
- Journal article
- Publication Details
- JAMA network open, Vol.7(9), e2435043
- DOI
- 10.1001/jamanetworkopen.2024.35043
- PMID
- 39269711
- PMCID
- PMC12163980
- NLM abbreviation
- JAMA Netw Open
- ISSN
- 2574-3805
- eISSN
- 2574-3805
- Publisher
- AMER MEDICAL ASSOC
- Grant note
- Physician Scientist Fund at Indianan University School of Medicine: R13DK137550-01
This work was supported in part by grant R13DK137550-01 and by the Physician Scientist Fund at Indianan University School of Medicine (to Dr Starr). Additionally, the in-person meeting was supported by educational grants from BioPorto Diagnostics, Indiana University Department of Pediatrics. and Nuwellis.
- Language
- English
- Date published
- 09/03/2024
- Academic Unit
- Nephrology, Dialysis and Transplantation; Stead Family Department of Pediatrics
- Record Identifier
- 9984704840102771
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