---
title: "Prematurity, Low Birth Weight, and CKD Risk: Intervention Opportunities for Small Vulnerable Newbo"
id: "pubmed-42836521"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42836521"
content_type: "clinical_feed_article"
specialty: "Critical Care"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42836521/"
doi: "10.1093/ndt/gfag230"
published_at: "2026-10-06T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Prematurity, Low Birth Weight, and CKD Risk: Intervention Opportunities for Small Vulnerable Newbo
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42836521
- **Specialty:** [Critical Care](https://medichelpline.com/clinical-feed/critical-care.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42836521/)
- **DOI:** [10.1093/ndt/gfag230](https://doi.org/10.1093%2Fndt%2Fgfag230)
- **Published At:** 2026-10-06T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- Preterm birth (<37 weeks), **low birth weight** (<2500 g) and **small for gestational age (SGA)** (birth weight <10th percentile) are related neonatal phenotypes that negatively affect lifelong kidney health. - These phenotypes are grouped under the term **small vulnerable newborn (SVN)**; SVN status is a major risk factor for early mortality and a lifelong predisposition to **chronic kidney disease (CKD)**. - Globally, about **35 million SVN** are born each year and will contribute to increasing CKD burden. - Reduced **nephron mass** in SVN results from interrupted nephrogenesis due to prematurity and from adverse intrauterine environments that impair nephron endowment. - Low nephron mass leads to maladaptive responses including **glomerular hyperfiltration**, glomerular hypertension and glomerular sclerosis. - Complications of prematurity can cause renal hypoperfusion; NICU pharmacologic treatments can be **nephrotoxic**, both increasing risk of neonatal **acute kidney injury (AKI)**. - Neonatal AKI is common in this population, associated with high acute mortality and considered a modifiable “second hit” on the pathway to CKD. - Preventive strategies cited include optimizing maternal health to reduce SVN births, improved detection and avoidance of neonatal AKI by reducing nephrotoxicity and kidney hypoperfusion during NICU care, and systematic documentation of AKI at discharge. - Clinicians and families should be educated about lifelong CKD risk in SVN survivors. - Follow-up should be stratified by completed gestational weeks, birth weight, occurrence of AKI and comorbidities, with aims to identify early and manage CKD progression factors and complications. - Keywords emphasized in the source: **chronic kidney disease**, **nephron mass**, **prematurity**, **small for gestational age**, and **intrauterine growth restriction**.
## Clinical Analysis & Structured Key Points
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Online ahead of print. # From prematurity and low birth weight to CKD: opportunities for intervention [Richard Klaus](https://pubmed.ncbi.nlm.nih.gov/?term=Klaus+R&cauthor_id=42836521)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42836521/#full-view-affiliation-1 "Department of Pediatrics, Dr. v. Hauner Children's Hospital, University Hospital, LMU Munich, Germany."), [Bärbel Lange-Sperandio](https://pubmed.ncbi.nlm.nih.gov/?term=Lange-Sperandio+B&cauthor_id=42836521)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42836521/#full-view-affiliation-1 "Department of Pediatrics, Dr. v. Hauner Children's Hospital, University Hospital, LMU Munich, Germany.") Affiliations Expand ### Affiliation * 1 Department of Pediatrics, Dr. v. Hauner Children's Hospital, University Hospital, LMU Munich, Germany. * PMID: **42836521** * DOI: [ 10.1093/ndt/gfag230 ](https://doi.org/10.1093/ndt/gfag230) Item in Clipboard # From prematurity and low birth weight to CKD: opportunities for intervention Richard Klaus et al. Nephrol Dial Transplant. 2026. Show details Display options Display options Format Abstract PubMed PMID Nephrol Dial Transplant Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Nephrol+Dial+Transplant%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Nephrol+Dial+Transplant%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42836521/) . 2026 Oct 6:gfag230. doi: 10.1093/ndt/gfag230. Online ahead of print. ### Authors [Richard Klaus](https://pubmed.ncbi.nlm.nih.gov/?term=Klaus+R&cauthor_id=42836521)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42836521/#short-view-affiliation-1 "Department of Pediatrics, Dr. v. Hauner Children's Hospital, University Hospital, LMU Munich, Germany."), [Bärbel Lange-Sperandio](https://pubmed.ncbi.nlm.nih.gov/?term=Lange-Sperandio+B&cauthor_id=42836521)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42836521/#short-view-affiliation-1 "Department of Pediatrics, Dr. v. Hauner Children's Hospital, University Hospital, LMU Munich, Germany.") ### Affiliation * 1 Department of Pediatrics, Dr. v. Hauner Children's Hospital, University Hospital, LMU Munich, Germany. * PMID: **42836521** * DOI: [ 10.1093/ndt/gfag230 ](https://doi.org/10.1093/ndt/gfag230) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID Linked Discoveries ## Abstract Preterm birth (<37 completed gestational weeks), low birth weight (<2500g) and small for gestational age (SGA, birth weight <10th percentile for gestational age) are interrelated neonatal phenotypes that adversely affect lifelong kidney health. They have been grouped under the term small vulnerable newborn (SVN). Being born as SVN ranks fifth among risk factors for early mortality and imposes a lifelong susceptibility for chronic kidney disease (CKD). The combination of extreme prematurity and SGA triples CKD-risk in early adulthood. Globally, around 35 million SVN are born annually and will contribute to rising CKD morbidity and mortality. In SVN, nephron mass is reduced because prematurity interrupts and an adverse intrauterine environment impairs nephron endowment. Maladaptive responses to low nephron mass include glomerular hyperfiltration, glomerular hypertension and glomerular sclerosis. In addition, complications of prematurity cause renal hypoperfusion and pharmacological treatment on the neonatal intensive care unit (NICU) can be nephrotoxic, both contributing to neonatal acute kidney injury (AKI). Neonatal AKI is common, has a high acute mortality and is a potentially modifiable second hit towards CKD. Preventive strategies include optimizing maternal health to prevent SVN, improved detection and avoidance of neonatal AKI by reduction of nephrotoxicity and kidney hypoperfusion during NICU-treatment and systematic documentation of AKI at discharge. Physicians and families should be educated about the child's lifelong CKD risk. Follow-up should be stratified by completed gestational weeks, birth weight, occurrence of AKI and comorbidities. Follow-up aims are early identification and treatment of CKD progression factors and complications. **Keywords:** chronic kidney disease; intrauterine growth restriction; nephron mass; prematurity; small for gestational age. © The Author(s) 2026. Published by Oxford University Press on behalf of the ERA. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site-for further information please contact journals.permissions@oup.com. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Similar articles * [ The Link Between Preterm Birth and Long-Term Renal Consequences: Current Knowledge and Emerging Therapeutic Targets. ](https://pubmed.ncbi.nlm.nih.gov/41898164/) Dotis J, Skarlatou A, Fourikou M, Papadopoulou A, Chochliourou E.Dotis J, et al.Biomedicines. 2026 Feb 26;14(3):517. doi: 10.3390/biomedicines14030517.Biomedicines. 2026.PMID: 41898164Free PMC article.Review. * [ Erratum. ](https://pubmed.ncbi.nlm.nih.gov/42814674/) [No authors listed][No authors listed]Kidney Blood Press Res. 2026;51(1):915-922. doi: 10.1159/kbr/adjag008. Epub 2026 Sep 30.Kidney Blood Press Res. 2026.PMID: 42814674 * [ Retinopathy of Prematurity. ](https://pubmed.ncbi.nlm.nih.gov/32965990/) Kaur K, Mikes BA.Kaur K, et al.2025 Jun 2. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan–.2025 Jun 2. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan–.PMID: 32965990Free Books & Documents. * [ The path to chronic kidney disease following acute kidney injury: a neonatal perspective. ](https://pubmed.ncbi.nlm.nih.gov/26809804/) Chaturvedi S, Ng KH, Mammen C.Chaturvedi S, et al.Pediatr Nephrol. 2017 Feb;32(2):227-241. doi: 10.1007/s00467-015-3298-9. Epub 2016 Jan 25.Pediatr Nephrol. 2017.PMID: 26809804Review. * [ Preterm birth and neonatal acute kidney injury: implications on adolescent and adult outcomes. ](https://pubmed.ncbi.nlm.nih.gov/32277164/) Harer MW, Charlton JR, Tipple TE, Reidy KJ.Harer MW, et al.J Perinatol. 2020 Sep;40(9):1286-1295. doi: 10.1038/s41372-020-0656-7. Epub 2020 Apr 10.J Perinatol. 2020.PMID: 32277164Review. 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