{
  "abstract": "Introduction\n\nExtremely preterm birth (< 28 weeks' gestation) increases chronic kidney disease (CKD) risk. However, among those born extremely preterm, the prevalence of abnormal kidney health during adolescence and its perinatal predictors remain poorly defined.Methods\n\nAdolescents from the Extremely Low Gestational Age Newborn -Environmental influences on Child Health Outcomes (ELGAN-ECHO) cohort (14 US hospitals) were assessed for abnormal kidney health defined as ≥ 1 indicator-chronic kidney disease in children (CKiD) U25 estimated glomerular filtration rate (eGFR) < 90 ml/min per 1.73 m², blood pressure (BP) ≥ 120/80 mm Hg, or microalbuminuria > 30 mg/g.Five feature selection methods screened perinatal covariate predictors using a 60 to 40 training-test split. Multiple imputation addressed missing data in sensitivity analyses. Area under the curve (AUC) was the primary performance metric.Results\n\nOf the 675 adolescents (mean age 18 years), 354 (52%) had a classifiable kidney health status, as follows: 188 with all 3 measurements and 166 with partial measurements showing ≥ 1 abnormality. The prevalence of abnormal kidney health was 66% among complete cases (125/188) and 82% among all determinate cases (291/354). In the full cohort, prevalence ranged from 43% to 91% (bounding estimates accounting for missing data). Individual measurements revealed 30.5% with reduced eGFR, 42% with elevated BP, and 9% with microalbuminuria. Across all methods, perinatal covariates achieved random test-set discrimination (AUC: 0.48-0.55) for abnormal kidney health prediction, compared with training set AUCs of 0.66-0.72.Conclusion\n\nAbnormal kidney health is highly prevalent after extremely preterm birth, underscoring the importance of protocolized longitudinal kidney health surveillance throughout childhood to enable early identification of CKD and elevated BP in children born extremely preterm. The perinatal factors we examined did not meaningfully predict kidney health abnormalities and variable importance did not translate to individual-level prediction in this cohort.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Pediatrics, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina USA.",
    "University of North Carolina Kidney Center, Division of Nephrology and Hypertension, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA.",
    "Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.",
    "Cecil G. Sheps Center for Health Services Research, University of North Carolina, Chapel Hill, North Carolina, USA.",
    "Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USA.",
    "Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.",
    "Division of Neonatology, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.",
    "Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.",
    "Division of Geriatric Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.",
    "Department of Environmental Sciences and Engineering, The University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina, USA."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 11,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Keia R Sanderson"
    },
    {
      "affs": [
        2
      ],
      "name": "Jesus E Vazquez"
    },
    {
      "affs": [
        1,
        3
      ],
      "name": "Jennifer E Flythe"
    },
    {
      "affs": [
        4
      ],
      "name": "David Askenazi"
    },
    {
      "affs": [
        5
      ],
      "name": "Michael R Kosorok"
    },
    {
      "affs": [
        5
      ],
      "name": "Minxin Lu"
    },
    {
      "affs": [
        6,
        7
      ],
      "name": "Kartikeya Makker"
    },
    {
      "affs": [
        0
      ],
      "name": "Matthew Laughon"
    },
    {
      "affs": [
        8
      ],
      "name": "Christine E Kistler"
    },
    {
      "affs": [
        9
      ],
      "name": "Rebecca C Fry"
    },
    {
      "affs": [
        0
      ],
      "name": "Thomas Michael O'Shea"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/5xf2g13gbmvn4.bib",
  "cited_by": 0,
  "doi": "10.1016/j.ekir.2026.107086",
  "fulltext_url": "https://europepmc.org/articles/PMC13681999",
  "id": "5xf2g13gbmvn4",
  "issns": [
    "2468-0249"
  ],
  "landing_url": "https://europepmc.org/article/MED/42903614",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2735|Birth, Development, and Health"
    ]
  ],
  "openalex": "W7213528188",
  "pdf_url": "https://europepmc.org/articles/PMC13681999?pdf=render",
  "pmcid": "PMC13681999",
  "pmid": "42903614",
  "published": "2026-09-17",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/5xf2g13gbmvn4.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:57Z",
      "native_id": "MED:42903614",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42903614"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2735|Birth, Development, and Health",
      "subfield": "reproductive-child"
    }
  ],
  "title": "High Prevalence and Limited Perinatal Prediction of Kidney Dysfunction in Adolescents Born Extremely Preterm.",
  "title_text": "High Prevalence and Limited Perinatal Prediction of Kidney Dysfunction in Adolescents Born Extremely Preterm.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:57Z",
  "url": "https://research.draconitic.com/paper/5xf2g13gbmvn4",
  "venue": "Kidney international reports",
  "versions": []
}