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

解决高危新生儿重症监护病房毕业生肾脏健康问题的共识研讨会

• 批准号: 10752851
• 负责人: Michelle C Starr
• 金额: $ 1.3万
• 依托单位: INDIANA UNIV-PURDUE UNIV AT INDIANAPOLIS
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-15 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10752851
• 关键词: Address; Admission activity; Adolescence; Adult; Advocacy; Age; Angiotensin-Converting Enzyme Inhibitors; Area; Blood Pressure Monitors; Caregivers; Caring; Child; Childhood; Chronic Kidney Failure; Clinical Research; Communities; Consensus Workshop; Critical Illness; Development; Disease Progression; Early identification; Educational workshop; End stage renal failure; Family; Fostering; Goals; Grant; Guidelines; Health; Health Services; Heart Diseases; High Prevalence; Intervention; Kidney; Kidney Diseases; Knowledge; Longitudinal Studies; Medical; Methods; Monitor; National Institute of Diabetes and Digestive and Kidney Diseases; Neonatal; Neonatal Intensive Care Units; Nephrology; Paper; Patient Discharge; Patients; Practice Guidelines; Pregnancy; Prevention; Process; Provider; Publishing; Quality of life; Recommendation; Renal function; Research; Research Infrastructure; Research Personnel; Research Priority; Risk; Sepsis; Testing; United States National Institutes of Health; Voting; Work; care providers; clinical care; clinical practice; congenital heart disorder; disorder risk; extreme prematurity; follow-up; high risk; high risk population; improved; interest; meetings; neonatal hypoxic-ischemic brain injury; neonate; pediatrician; premature; preterm newborn; prevent; renal damage; working group

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.

慢性肾脏疾病（CKD）在需要护理的新生儿中常见于新生儿重症监护病房 （NICU），尤其是在过早的新生儿，重症新生儿和先天性心脏病患者。 对出生的儿童长期肾功能的研究表明，CKD的增加了三倍。 青少年到成年。 CKD的燃烧将继续增加，因为更早产 新生儿一直存活到成年，生存能力的阈值持续下降超过22周的妊娠。 尽管已知的CKD风险因新生儿NICU排出，但目前没有建议概述谁 应监视CKD，应监视它们或应进行哪种类型的测试 肾脏健康监测。此外，我们对必要的下一步和 新生儿肾脏病研究和临床护理的机会，这导致缺乏动力 新生儿肾脏病社区。为了填补这些知识差距，我们提出“共识研讨会 在高风险的新生儿重症监护病房毕业生中介绍肾脏健康，以下目的：1） 在NICU出院后，开发基于专家的肾脏健康监测指南 组，2）确定新生儿肾脏病研究和临床护理的差距，重点是肾脏健康和CKD NICU出院和3）发展工作组以开始缩小新生儿肾脏病中的这些差距， NICU出院后，专注于肾脏健康和CKD。成功完成此研讨会将导致 提出建议，以帮助临床医生确定谁，何时以及如何评估肾脏 NICU毕业生的健康。这些建议不仅可以改善临床护理，而且还可以 还将有助于改善我们进行研究的方式。我们还将确定研究和临床护理的重点 新生儿肾脏病，重点关注NICU毕业生的肾脏健康和CKD风险。最后，我们将发展 合作研究小组以确定的新生儿肾脏病的优先区域为基础 在研讨会期间，允许就如何解决这些差距进行对话。最终产品将是 建立研究基础设施，这将为NIH授予授予的阶段。将 在研讨会期间完成对通过NIH作为实用临床研究的未来研究至关重要 而多中心协作工作需要对肾脏的最佳实践有共同的了解 健康监测。该研讨会将汇集一个潜水员和代表性的小儿和成人 肾脏科医生，新生儿学家，心脏病学家，兴奋家，儿科医生，卫生服务研究人员，患者和患者 家庭和倡导专家以实现上述目标。此外，通过让学员积极参与 制定后续指南，研究和临床护理差距的识别以及形成 协作工作组，我们努力在新生儿肾脏学领域进一步发展研究管道。