Framework for Kidney Health Follow‐Up Among Neonates With Critical Cardiac Disease: A Report From the Neonatal Kidney Health Consensus Workshop
Acute kidney injury is common among neonates with critical cardiac disease. Risk factors and associations with kidney‐related outcomes are heterogeneous and distinct from other neonates. As survival of children with critical cardiac disease increases to adulthood, the burden of chronic kidney diseas...
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| Published in: | Journal of the American Heart Association Vol. 14; no. 6; p. e040630 |
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| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
England
John Wiley and Sons Inc
18.03.2025
Wiley |
| Subjects: | |
| ISSN: | 2047-9980, 2047-9980 |
| Online Access: | Get full text |
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| Abstract | Acute kidney injury is common among neonates with critical cardiac disease. Risk factors and associations with kidney‐related outcomes are heterogeneous and distinct from other neonates. As survival of children with critical cardiac disease increases to adulthood, the burden of chronic kidney disease is increasing. Thirty percent to 50% of adults with congenital heart disease have impaired kidney function, even in the absence of prior kidney injury episodes. This may be related to the current standardized acute kidney injury criteria, which may not fully capture clinically meaningful kidney injury and long‐term kidney health risks. An improved understanding of which neonates with critical cardiac disease should undergo kidney health follow‐up is imperative. During the National Institutes of Health–supported Neonatal Kidney Health Consensus Workshop to Address Kidney Health meeting conducted in February 2024, a panel of 51 neonatal nephrology experts focused on at‐risk groups: (1) preterm infants, (2) critically ill infants with acute kidney injury, and (3) infants with critical cardiac disease. The critical cardiac disease subgroup, comprising multidisciplinary experts, used a modified Delphi process to achieve consensus on recommendations for kidney health follow‐up. In this report, we review available data on kidney health follow‐up in critical cardiac disease and summarize the 2 consensus‐based recommendations. We introduce novel diagnostic and risk‐stratification tools for acute kidney injury diagnosis in neonates with cardiac disease to guide follow‐up recommendations. Finally, we identify important knowledge gaps, representing areas of focus for future research. These should be prioritized to understand and improve long‐term kidney health in critical cardiac disease. |
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| AbstractList | Acute kidney injury is common among neonates with critical cardiac disease. Risk factors and associations with kidney‐related outcomes are heterogeneous and distinct from other neonates. As survival of children with critical cardiac disease increases to adulthood, the burden of chronic kidney disease is increasing. Thirty percent to 50% of adults with congenital heart disease have impaired kidney function, even in the absence of prior kidney injury episodes. This may be related to the current standardized acute kidney injury criteria, which may not fully capture clinically meaningful kidney injury and long‐term kidney health risks. An improved understanding of which neonates with critical cardiac disease should undergo kidney health follow‐up is imperative. During the National Institutes of Health–supported Neonatal Kidney Health Consensus Workshop to Address Kidney Health meeting conducted in February 2024, a panel of 51 neonatal nephrology experts focused on at‐risk groups: (1) preterm infants, (2) critically ill infants with acute kidney injury, and (3) infants with critical cardiac disease. The critical cardiac disease subgroup, comprising multidisciplinary experts, used a modified Delphi process to achieve consensus on recommendations for kidney health follow‐up. In this report, we review available data on kidney health follow‐up in critical cardiac disease and summarize the 2 consensus‐based recommendations. We introduce novel diagnostic and risk‐stratification tools for acute kidney injury diagnosis in neonates with cardiac disease to guide follow‐up recommendations. Finally, we identify important knowledge gaps, representing areas of focus for future research. These should be prioritized to understand and improve long‐term kidney health in critical cardiac disease. Acute kidney injury is common among neonates with critical cardiac disease. Risk factors and associations with kidney-related outcomes are heterogeneous and distinct from other neonates. As survival of children with critical cardiac disease increases to adulthood, the burden of chronic kidney disease is increasing. Thirty percent to 50% of adults with congenital heart disease have impaired kidney function, even in the absence of prior kidney injury episodes. This may be related to the current standardized acute kidney injury criteria, which may not fully capture clinically meaningful kidney injury and long-term kidney health risks. An improved understanding of which neonates with critical cardiac disease should undergo kidney health follow-up is imperative. During the National Institutes of Health-supported Neonatal Kidney Health Consensus Workshop to Address Kidney Health meeting conducted in February 2024, a panel of 51 neonatal nephrology experts focused on at-risk groups: (1) preterm infants, (2) critically ill infants with acute kidney injury, and (3) infants with critical cardiac disease. The critical cardiac disease subgroup, comprising multidisciplinary experts, used a modified Delphi process to achieve consensus on recommendations for kidney health follow-up. In this report, we review available data on kidney health follow-up in critical cardiac disease and summarize the 2 consensus-based recommendations. We introduce novel diagnostic and risk-stratification tools for acute kidney injury diagnosis in neonates with cardiac disease to guide follow-up recommendations. Finally, we identify important knowledge gaps, representing areas of focus for future research. These should be prioritized to understand and improve long-term kidney health in critical cardiac disease.Acute kidney injury is common among neonates with critical cardiac disease. Risk factors and associations with kidney-related outcomes are heterogeneous and distinct from other neonates. As survival of children with critical cardiac disease increases to adulthood, the burden of chronic kidney disease is increasing. Thirty percent to 50% of adults with congenital heart disease have impaired kidney function, even in the absence of prior kidney injury episodes. This may be related to the current standardized acute kidney injury criteria, which may not fully capture clinically meaningful kidney injury and long-term kidney health risks. An improved understanding of which neonates with critical cardiac disease should undergo kidney health follow-up is imperative. During the National Institutes of Health-supported Neonatal Kidney Health Consensus Workshop to Address Kidney Health meeting conducted in February 2024, a panel of 51 neonatal nephrology experts focused on at-risk groups: (1) preterm infants, (2) critically ill infants with acute kidney injury, and (3) infants with critical cardiac disease. The critical cardiac disease subgroup, comprising multidisciplinary experts, used a modified Delphi process to achieve consensus on recommendations for kidney health follow-up. In this report, we review available data on kidney health follow-up in critical cardiac disease and summarize the 2 consensus-based recommendations. We introduce novel diagnostic and risk-stratification tools for acute kidney injury diagnosis in neonates with cardiac disease to guide follow-up recommendations. Finally, we identify important knowledge gaps, representing areas of focus for future research. These should be prioritized to understand and improve long-term kidney health in critical cardiac disease. |
| Author | Soranno, Danielle E. Isaac, Jaya S. Beck, Tara Stoops, Christine C. Selewski, David T. Ahmad, Kaashif A. Menon, Shina Chaudhry, Paulomi Bignall, O.N. Ray Segar, Jeffret L. Obregon, Evelyn Todukar, Namrata Merrill, Kyle A. Steflik, Heidi J. Ambalavanan, Namasivavam Gillen, Matthew C. Condit, Paige E. Jackson, Caroline V. Schwartz, Samantha R. Gist, Katja M. Abotol, Carolyn L. Schuh, Meredith P. Lowe, Kathryn J. Reidy, Kimberly J. Charlton, Jennifer R. Laster, Marcian A. Gorga, Stephen M. Mohamed, Tahagod H. Rajadhyaksha, Evan A. Slagle, Cara L. Hanna, Mina Marcuccilli, Morgan E. Short, Kara C. Starr, Michelle C. Krawczeski, Catherine D. Niemviski, Emily A. Rademacher, Erin R. Deford, Amanda B. Harer, Matthew W. Liberio, Brianna M. DeFreitas, Marissa J. Feeney, Alex Guillet, Ronnie Sanderson, Keia R. Askenazi, David J. Vuong, Kim T. Joseph, Catherine Jetton, Jennifer G. Chmielewski, Jennifer L. Fuhrman, Dana Y. Rumple, Jennifer A. Kwiatkowski, David M. |
| AuthorAffiliation | 3 Indiana University School of Medicine Riley Hospital for Children Indianapolis IN USA 5 Baylor College of Medicine Texas Children’s Hospital Houston TX USA 9 Division of Child Health Service Research, Department of Pediatrics Indiana University School of Medicine Indianapolis IN USA 2 University of Pittsburgh School of Medicine UPMC Pittsburgh Children’s Hospital Pittsburgh PA USA 8 Division of Pediatric Nephrology, Department of Pediatrics Indiana University School of Medicine Indianapolis IN USA 10 Division of Neonatology, Department of Pediatrics University of Wisconsin School of Medicine and Public Health Madison WI USA 13 Division of Pediatric Nephrology, Department of Pediatrics Medical University of South Carolina Charleston SC USA 1 University of Michigan Medical School C.S. Mott Children’s Hospital Ann Arbor MI USA 11 Division of Pediatric Nephrology, Department of Pediatrics University of Virginia School of Medicine Charlottesville VA USA 6 The Ohio State University College of Medic |
| AuthorAffiliation_xml | – name: 11 Division of Pediatric Nephrology, Department of Pediatrics University of Virginia School of Medicine Charlottesville VA USA – name: 12 Division of Pediatric Nephrology, Department of Pediatrics University of Alabama at Birmingham Birmingham AL USA – name: 8 Division of Pediatric Nephrology, Department of Pediatrics Indiana University School of Medicine Indianapolis IN USA – name: 14 University of Cincinnati College of Medicine Cincinnati Children’s Hospital Medical Center Cincinnati OH USA – name: 2 University of Pittsburgh School of Medicine UPMC Pittsburgh Children’s Hospital Pittsburgh PA USA – name: 9 Division of Child Health Service Research, Department of Pediatrics Indiana University School of Medicine Indianapolis IN USA – name: 6 The Ohio State University College of Medicine Nationwide Children’s Hospital Columbus OH USA – name: 13 Division of Pediatric Nephrology, Department of Pediatrics Medical University of South Carolina Charleston SC USA – name: 3 Indiana University School of Medicine Riley Hospital for Children Indianapolis IN USA – name: 7 Stanford University School of Medicine Lucile Packard Children’s Hospital Palo Alto CA USA – name: 4 University of Miami Miller School of Medicine Holtz Children’s Hospital Miami FL USA – name: 10 Division of Neonatology, Department of Pediatrics University of Wisconsin School of Medicine and Public Health Madison WI USA – name: 1 University of Michigan Medical School C.S. Mott Children’s Hospital Ann Arbor MI USA – name: 5 Baylor College of Medicine Texas Children’s Hospital Houston TX USA |
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| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/40079314$$D View this record in MEDLINE/PubMed |
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| ContentType | Journal Article |
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| Copyright | 2025 The Author(s). Published on behalf of the American Heart Association, Inc., by Wiley. |
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| Keywords | renal kidney health neonate chronic kidney cardiac |
| Language | English |
| License | This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
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| Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 ObjectType-Review-3 content type line 23 This manuscript was sent to Daniel E. Clark, MD, MPH, Assistant Editor, for review by expert referees, editorial decision, and final disposition. For Sources of Funding and Disclosures, see page 13. A complete list of the Neonatal Kidney Health Consensus Workshop collaborators and investigators can be found in the appendix at the end of the article. |
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| PublicationTitle | Journal of the American Heart Association |
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| SubjectTerms | Acute Kidney Injury - diagnosis Acute Kidney Injury - epidemiology Acute Kidney Injury - etiology Acute Kidney Injury - physiopathology Acute Kidney Injury - therapy cardiac chronic kidney Consensus Critical Illness health Heart Defects, Congenital - complications Heart Diseases - complications Humans Infant, Newborn kidney neonate renal Renal Insufficiency, Chronic - diagnosis Renal Insufficiency, Chronic - epidemiology Risk Factors Special Report |
| Title | Framework for Kidney Health Follow‐Up Among Neonates With Critical Cardiac Disease: A Report From the Neonatal Kidney Health Consensus Workshop |
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