Long-Term Brain White Matter Outcomes Following Neonatal Acute Kidney Injury

Ryan C Ward; Emily J Steinbach; Peg Nopoulos; Ellen van der Plas; Lauren Hopkins; Danielle E Soranno; Amy L Conrad; Lyndsay A Harshman

doi:10.64898/2026.06.24.26356471

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Long-Term Brain White Matter Outcomes Following Neonatal Acute Kidney Injury

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Long-Term Brain White Matter Outcomes Following Neonatal Acute Kidney Injury

Ryan C Ward, Emily J Steinbach, Peg Nopoulos, Ellen van der Plas, Lauren Hopkins, Danielle E Soranno, Amy L Conrad and Lyndsay A Harshman

medRxiv : the preprint server for health sciences

Cold Spring Harbor Laboratory

07/01/2026

DOI: 10.64898/2026.06.24.26356471

PMID: 42428099

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https://doi.org/10.64898/2026.06.24.26356471View

Preprint (Author's original) This preprint has not been evaluated by subject experts through peer review. Preprints may undergo extensive changes and/or become peer-reviewed journal articles. Open Access

Abstract

Acute kidney injury (AKI) is common among neonates in the intensive care unit and has been linked to abnormal neurodevelopment, yet long-term effects on brain structure remain uncharacterized. In this secondary analysis, we compared brain white matter integrity, measured by fractional anisotropy (FA) on 3T MRI, in children ages 5-12 years born preterm with (n=5) versus without (n=10) a history of neonatal AKI. Contrary to our hypothesis, children with prior neonatal AKI showed FA across seven white matter regions in unadjusted analyses. After adjustment for sex, birth weight, and age at MRI, the AKI group retained significantly greater FA in the corticospinal tract (β=0.7, 95% CI 0.09-1.31) and superior frontooccipital fasciculus (β=0.68, 95% CI 0.02-1.34). Because elevated FA may reflect compensatory glial responses rather than improved neurological function, these findings suggest neonatal AKI may have lasting, complex effects on white matter microstructure. Larger studies pairing neuroimaging with neurocognitive assessment are needed.

Details

Title: Subtitle: Long-Term Brain White Matter Outcomes Following Neonatal Acute Kidney Injury
Creators: Ryan C Ward - University of Iowa
Emily J Steinbach - University of Iowa
Peg Nopoulos - University of Iowa
Ellen van der Plas - Arkansas Children's Hospital
Lauren Hopkins - University of Iowa
Danielle E Soranno - Indiana University School of Medicine
Amy L Conrad - University of Iowa
Lyndsay A Harshman - University of Iowa
Resource Type: Preprint
Publication Details: medRxiv : the preprint server for health sciences
DOI: 10.64898/2026.06.24.26356471
PMID: 42428099
Publisher: Cold Spring Harbor Laboratory; United States
Language: English
Date posted: 07/01/2026
Academic Unit: Neurology; Psychiatry; Pediatric Psychology; Nephrology, Dialysis and Transplantation; Stead Family Department of Pediatrics; Iowa Neuroscience Institute; Craniofacial Anomalies Research Center
Record Identifier: 9985180876902771

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