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.

慢性肾病（CKD）在需要新生儿重症监护病房护理的新生儿中很常见 (NICU)，特别是早产儿、危重新生儿和患有先天性心脏病的新生儿。 对早产儿长期肾功能的研究表明，慢性肾病 (CKD) 增加三倍 青春期和成年后，慢性肾病（CKD）的负担将继续增加，尤其是早产。 新生儿可以存活到成年，并且在妊娠 22 周后生存能力阈值继续下降。 尽管从 NICU 出院的新生儿存在已知的 CKD 风险，但目前尚无建议概述哪些人 应监测 CKD、何时应监测或应进行什么类型的测试 此外，我们对必要的后续步骤和肾脏健康监测的理解存在差距。 新生儿肾病学研究和临床护理的机会，这导致缺乏动力 为了填补这些关键知识空白，我们提出了“共识研讨会”。 解决高危新生儿重症监护病房毕业生的肾脏健康问题”，目标如下：1) 为三名高危新生儿 NICU 出院后的肾脏健康监测制定专家指导 小组，2) 确定新生儿肾病学研究和临床护理方面的差距，重点关注肾脏健康和 CKD NICU 出院后，以及 3) 建立工作组以开始缩小新生儿肾病学方面的差距， 重点关注 NICU 出院后的肾脏健康和 CKD。 制定建议以协助确定谁、何时以及如何评估肾脏 这些建议不仅可以改善临床护理，而且可以改善 NICU 毕业生的健康状况。 还将帮助改善我们进行研究的方式，我们还将确定以下方面的研究和临床护理优先事项。 新生儿肾病学，重点关注 NICU 毕业生的肾脏健康和 CKD 风险。 合作研究小组将建立在已确定的新生儿肾病优先领域的基础上 在研讨会期间，并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，这将为向 NIH 提交资助奠定基础。 研讨会期间完成的任务对于 NIH 作为实用临床研究的未来研究至关重要 多中心协作工作需要对肾脏方面的最佳实践有共同的理解 该研讨会将汇集具有代表性的儿童和成人团体。 肾脏科医生、新生儿科医生、心脏病专家、重症监护医生、儿科医生、卫生服务研究人员、患者和患者 此外，还通过让受训者积极参与来实现上述目标。 制定后续指南、确定研究和临床护理差距以及形成 合作工作组，我们努力进一步发展新生儿肾病学领域的研究渠道。