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Global economic burden of neonatal acute kidney injury (AKI): the hidden costs of medical elopement

Journal of Perinatology (2026)Cite this article

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To the Editor,

The study by Steflik et al. characterizing the substantial economic burden of neonatal acute kidney injury (AKI) within the Pediatric Health Information System (PHIS) is both relevant and timely [1]. The authors demonstrate that AKI is independently associated with an adjusted cost increase of approximately $58,000 per hospitalization. Crucially, they highlight that these costs are inversely related to gestational age and are primarily mediated by a significantly prolonged length of hospitalization (LOH). These findings align with a growing body of evidence linking neonatal AKI to extended hospitalizations and, consequently, resource utilization [2].

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References

  1. Steflik HJ, Selewski DT, Corrigan C, Brinton DL. Acute kidney injury associated with increased costs in the neonatal intensive care unit: analysis of Pediatric Health Information System database. J Perinatol. 2025;45:94–100.

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  2. Jetton JG, Boohaker LJ, Sethi SK, Wazir S, Rohatgi S, Soranno DE, et al. Incidence and outcomes of neonatal acute kidney injury (AWAKEN): a multicentre, multinational, observational cohort study. Lancet Child Adolesc Health. 2017;1:184–94.

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Authors and Affiliations

  1. Boston Children’s Hospital, Boston, MA, USA

    Sitarah Mathias

  2. Harvard Medical School, Boston, MA, USA

    Sitarah Mathias

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  1. Sitarah Mathias
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Author SM conceptualized, drafted, and finalized the entire manuscript (correspondence) independently.

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Correspondence to Sitarah Mathias.

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Mathias, S. Global economic burden of neonatal acute kidney injury (AKI): the hidden costs of medical elopement. J Perinatol (2026). https://doi.org/10.1038/s41372-026-02626-9

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