Kidney Week

Abstract: FR-PO0925

Early Anemia Burden and Treatment Escalation in Neonates Subsequently Diagnosed with CKD

Session Information

• Pediatric Nephrology: Genetic Diseases, Development, Neonatal Nephrology, Glomerular Diseases, and More
  October 23, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Pediatric Nephrology

• 1800 Pediatric Nephrology

Authors

• Uni, Rie, Weill Cornell Medicine, New York, New York, United States

Rie Uni, MD, PhD

• Bani Hani, Salar, Loma Linda University, Loma Linda, California, United States

Salar Bani Hani, MD, MBBS

• Lee, Juhong, Weill Cornell Medicine, New York, New York, United States

Juhong Lee

• Nadroo, Ali M., Weill Cornell Medicine, New York, New York, United States

Ali M. Nadroo, MD

• Martin, Camilia R., Weill Cornell Medicine, New York, New York, United States

Camilia R. Martin, MD, MS

• Akchurin, Oleh M., Weill Cornell Medicine, New York, New York, United States

Oleh M. Akchurin, MD, PhD, FASN

Background

Anemia is a common and clinically significant complication in critically ill neonates with congenital kidney dysfunction requiring neonatal intensive care unit (NICU) care. While the relationship between kidney dysfunction and anemia is well established in adults, data in neonatal populations are limited. Prior studies have primarily focused on anemia as a risk factor for AKI. However, it remains unclear whether early kidney dysfunction contributes to anemia in neonates, particularly among those who later develop CKD.

Methods

This retrospective cohort study included NICU patients subsequently diagnosed with CKD and referred to a pediatric nephrology clinic within the first 12 months of life (CKD group). Infants who received NICU care but had normal serum creatinine levels after discharge within the first two years of life served as controls.

Results

We identified 30 patients with CKD and 20 control patients. CKD was attributed to congenital anomalies of the kidney and urinary tract in 88% of cases. Compared with controls, fewer patients in the CKD group were born preterm (40% vs 75%) and required intubation (13% vs 25%). Peak and nadir hemoglobin (Hb) levels during the NICU stay did not differ significantly between groups. However, patients with CKD more frequently received blood transfusions and erythropoiesis−stimulating agents (ESAs). Among patients with CKD, 58% received iron supplementation, 37% received ESAs, and 23% received blood transfusions. Advanced CKD stage at 12 months was associated with more frequent ESA use in the NICU.
There was a significant inverse correlation between nadir Hb and peak serum creatinine during the NICU stay in both groups. Additionally, lower eGFR at 12 months was associated with lower nadir Hb levels during NICU hospitalization. Among CKD patients treated with iron, iron status was assessed in only 35%, with half demonstrating iron deficiency.

Conclusion

These findings suggest that kidney dysfunction may contribute to anemia in the NICU, a relationship that may be under−recognized in intensive care settings. Infrequent assessment of iron status highlights an additional opportunity to improve care.

Funding

• NIDDK Support