In this secondary analysis of the multicenter PENUT trial, we describe fluid-corrected acute kidney injury (AKI) and evaluate associations with short-term and long-term outcomes in premature neonates with fluid-corrected AKI.

Taken together, the current study suggests a paradigm shift in how we describe kidney function in premature neonates in the first 2 postnatal weeks.

The current study suggests that fluid balance should be considered in future definitions to improve the diagnosis of AKI in premature neonates.

Failing to correct serum creatinine for fluid balance underestimates the prevalence and severity of AKI in premature neonates.

Future studies should consider correcting AKI for fluid balance in the first 2 weeks to improve identification of neonates at high risk for poor outcomes.

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