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Am J Perinatol 2026; 43(03): 418-421
DOI: 10.1055/a-2608-0889
Short Communication

Current Practice of Kidney Support Therapy in the NICU: Results from a CHNC Survey

Authors

  • Christine Stoops 

    1   Division of Neonatology, University of Alabama at Birmingham, Birmingham, Alabama
    2   Division of Neonatology, Children's of Alabama, Birmingham, Alabama

  • Sofia I. Perazzo

    3   Division of Neonatology, Children's National Hospital, Washington, Dist. of Columbia
    4   Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, Washington, Dist. of Columbia

  • Jennifer A. Rumpel

    5   Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas

  • Tahagod Mohamed

    6   Division of Nephrology and Hypertension, Nationwide Children's Hospital, Columbus, Ohio

  • Andrew M. South

    7   Atrium Health Levine Children's Brenner Children's Hospital, Wake Forest University School of Medicine, Winston-Salem, North Carolina

  • Mona Khattab

    8   Division of Neonatology, Baylor College of Medicine, Houston, Texas

  • Catherine Joseph

    9   Division of Pediatric Nephrology, Baylor College of Medicine, Houston, Texas

  • Matthew W. Harer 

    10   Division of Neonatology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin

  • Cara L. Slagle

    11   Riley Hospital for Children and Indiana University School of Medicine, Indianapolis, Indiana

  • Mary Revenis

    3   Division of Neonatology, Children's National Hospital, Washington, Dist. of Columbia
    4   Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, Washington, Dist. of Columbia

  • John Daniel IV

    12   Division of Neonatology, Department of Pediatrics, Children's Mercy Hospital and Clinics, Kansas City, Missouri
    • on behalf of the Children's Hospital Neonatal Consortium Kidney Focus Group subcommittee on Kidney Support Therapy

Funding J.A.R. was supported by the Arkansas Biosciences Institute, the National Center for Advancing Translational Sciences of the National Institutes of Health (NIH; grant no.: KL2TR003108), and the Marion B. Lyon New Scientist Development Award through the Arkansas Children's Research Institute. A.M.S. was supported by the NIH NHLBI (grant nos.: K23HL148394, R01HL146818, and R01HL164434). C.L.S. is a consultant for Mozarc Medical.
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Abstract

Objectives

In a survey conducted within the Children’s Hospital Neonatal Consortium (CHNC), the Kidney Focus Group aimed to describe the resource and practice variations among participating level IV neonatal intensive care units.

Study Design

A 24-question survey was developed by neonatologists and pediatric nephrologists who belong to the Kidney Support Therapy (KST) subgroup of the CHNC Kidney Focus Group.

Results

The majority (89.5%) of responding centers offered some form of KST, with > 90% centers offered prenatal consultations. The most common KST modality offered were peritoneal dialysis (PD) and continuous renal replacement therapy (CRRT) while on ECMO. Prismaflex was the most common device used for stand-alone CRRT. The most common indication for KST initiation was fluid overload and body weight was indicated as the most common limiting factor with the majority of centers reporting weight limitation ≤ 1.5-2 kg.

Conclusion

Advances in technology have made it possible to offer KST to a wider neonatal population than before. However, the availability of such technologies can vary significantly among institutions in addition to diversity of clinical experience and standardized protocols. This survey provides valuable insights into current KST practices across 19 level IV NICUs within the CHNC demonstrating expected practice variations amongst centers that may be dependent on location, center resources, and subspecialty providers, among others.

Key Points

  • Considerable practice variation exists in KST among NICUs.

  • Majority of NICUs utilize multi-disciplinary involvement, but subspecialties vary widely.

  • The most common indication for KST initiation was fluid overload.

Keywords

kidney support therapy - NICU - neonatal - kidney - renal replacement therapy

Patient Consent

Patient consent was not required for this study, IRB approved at Children's Mercy Hospitals and Clinics.


Authors' Contributions

C.S.: Significant contributions to the design and conception, data analysis and interpretation, drafting of the manuscript, critical revision of the manuscript, and final approval.

S.P., J.A.R., and J.D.: Contributions to the design and conception, data analysis, interpretation, and critical revision of the manuscript.

T.M., A.M.S., M.K., C.J., M.H., C.L.S., and M.R.: Contributions to design and revision of the manuscript.




Publication History

Received: 09 April 2025

Accepted: 13 May 2025

Article published online:
10 June 2025

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