{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T10:51:26Z","timestamp":1785408686675,"version":"3.56.0"},"posted":{"date-parts":[[2026,7,1]]},"group-title":"Pediatrics","reference-count":10,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/"}],"funder":[{"award":["5P01HL046925-25"],"award-info":[{"award-number":["5P01HL046925-25"]}],"id":[{"id":"https:\/\/ror.org\/01cwqze88","id-type":"ROR","asserted-by":"publisher"}]},{"award":["R01DK128835"],"award-info":[{"award-number":["R01DK128835"]}],"id":[{"id":"https:\/\/ror.org\/01cwqze88","id-type":"ROR","asserted-by":"publisher"}]},{"award":["R37CA266145"],"award-info":[{"award-number":["R37CA266145"]}],"id":[{"id":"https:\/\/ror.org\/01cwqze88","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2026,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:p>\n                  Acute kidney injury (AKI) is common among neonates in the intensive care unit and has been linked to abnormal neurodevelopment, yet long-term effects on brain structure remain uncharacterized. In this secondary analysis, we compared brain white matter integrity, measured by fractional anisotropy (FA) on 3T MRI, in children ages 5-12 years born preterm with (n=5) versus without (n=10) a history of neonatal AKI. Contrary to our hypothesis, children with prior neonatal AKI showed\n                  <jats:italic>higher<\/jats:italic>\n                  FA across seven white matter regions in unadjusted analyses. After adjustment for sex, birth weight, and age at MRI, the AKI group retained significantly greater FA in the corticospinal tract (\u03b2=0.7, 95% CI 0.09-1.31) and superior frontooccipital fasciculus (\u03b2=0.68, 95% CI 0.02-1.34). Because elevated FA may reflect compensatory glial responses rather than improved neurological function, these findings suggest neonatal AKI may have lasting, complex effects on white matter microstructure. Larger studies pairing neuroimaging with neurocognitive assessment are needed.\n                <\/jats:p>","DOI":"10.64898\/2026.06.24.26356471","type":"posted-content","created":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T02:25:19Z","timestamp":1782959119000},"source":"Crossref","is-referenced-by-count":0,"title":["Long-Term Brain White Matter Outcomes Following Neonatal Acute Kidney Injury"],"prefix":"10.64898","author":[{"given":"Ryan C.","family":"Ward","sequence":"first","affiliation":[{"name":"Stead Family Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily J.","family":"Steinbach","sequence":"additional","affiliation":[{"name":"Stead Family Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peg","family":"Nopoulos","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7490-6636","authenticated-orcid":false,"given":"Ellen","family":"van der Plas","sequence":"additional","affiliation":[{"name":"University of Arkansas for Medical Sciences, Department of Pediatrics, Little Rock, AR, USA"},{"name":"Arkansas Children\u2019s Hospital Research Institute, Division of Hematology\/Oncology, Little Rock, AR, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren","family":"Hopkins","sequence":"additional","affiliation":[{"name":"Department of Molecular Physiology and Biophysics, University of Iowa, Iowa City, Iowa, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle E.","family":"Soranno","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Nephrology, Indiana University School of Medicine, Indianapolis, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy L.","family":"Conrad","sequence":"additional","affiliation":[{"name":"Stead Family Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4952-8132","authenticated-orcid":false,"given":"Lyndsay A.","family":"Harshman","sequence":"additional","affiliation":[{"name":"Stead Family Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"54368","reference":[{"issue":"3","key":"2026070401400744000_2026.06.24.26356471v1.1","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1016\/S2352-4642(17)30069-X","article-title":"Incidence and outcomes of neonatal acute kidney injury (AWAKEN): a multicentre, multinational, observational cohort study","volume":"1","year":"2017","journal-title":"Lancet Child Adolesc Health"},{"key":"2026070401400744000_2026.06.24.26356471v1.2","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2007080901"},{"issue":"9","key":"2026070401400744000_2026.06.24.26356471v1.3","doi-asserted-by":"crossref","first-page":"2789","DOI":"10.1007\/s00467-024-06287-8","article-title":"Acute kidney injury in neonates with hypoxic ischemic encephalopathy based on serum creatinine decline compared to KDIGO criteria","volume":"39","year":"2024","journal-title":"Pediatr 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