Understanding Kidney Impacts in Children with HIE
March 10th, 2026 | Care
| News
Every March, Kidney Awareness Month shines a light on the vital role kidneys play in overall health. For families and clinicians connected to hypoxic ischemic encephalopathy (HIE), kidney health is an important but often less discussed part of the story.
While HIE is primarily known as a type of newborn brain injury caused by reduced oxygen and blood flow around the time of birth, it is increasingly recognized as a whole-body condition and can happen outside of the neonatal period for many reasons. The same event that affects the brain can also impact other organs, including the kidneys.
Understanding these connections helps families, clinicians, and researchers work toward better monitoring, better treatments, and better long-term outcomes.
Five Fast Facts:
- HIE can affect multiple organs, not just the brain:
Although HIE is typically described as a brain injury, the oxygen deprivation that causes it can affect multiple organs throughout the body. The kidneys, heart, liver, and lungs are all sensitive to reduced oxygen and blood flow.
For this reason, medical teams caring for children with HIE—whether in the NICU or pediatric ICU—carefully monitor multiple organ systems during recovery.
- Kidney injury can occur after oxygen deprivation:
The kidneys require a constant supply of oxygen-rich blood to function properly. When oxygen and circulation are disrupted during an HIE event, the kidneys may experience acute kidney injury (AKI).
In newborns with moderate to severe HIE, studies suggest that 30–50% experience AKI during the neonatal period. Kidney injury can also occur in older infants and children following pediatric-acquired HIE events.
- Many children recover kidney function:
For many babies and children, kidney injury following HIE improves with supportive medical care as the body stabilizes and recovers from the initial event.
During hospitalization, care teams monitor urine output, blood markers, and electrolyte levels to ensure the kidneys are functioning and to guide treatment when needed.
- Kidney outcomes can vary along a spectrum:
Just like neurological outcomes after HIE exist along a range, kidney outcomes can vary as well.
Some children experience kidney injury that fully resolves, while others may have ongoing kidney concerns that require monitoring, medication, or temporary dialysis. In more rare cases, significant kidney disease may develop that requires long-term dialysis or kidney transplant.
- We still need more long-term research:
While kidney injury during the acute phase of HIE is recognized in clinical care, long-term kidney outcomes in children who experienced HIE are not yet well understood.
More research and long-term follow-up are needed to understand:
- Medications that can prevent or reduce the degree of kidney injury
- New approaches to diagnose kidney injury.
- Novel approaches to dialysis for small children.
- How to best approach long-term monitoring of children with HIE
- Treatments to optimize long-term kidney outcomes
Understanding these questions will help clinicians provide more comprehensive care for children affected by both neonatal and pediatric-acquired HIE. It is our hope that with initiatives like the HIE Research Registry, and collaborating with other groups like the Neonatal Kidney Collaborative, we will be able to answer these questions and improve care and outcomes.
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