**4.2.2 Ventilation**

The mode of ventilation of the preterm infant also has the potential to impact on the developing kidney, since alterations in airway pressure are reported to lead to significant cardiopulmonary haemodynamic changes (Polglase et al., 2009) which may subsequently affect renal perfusion. For instance, mechanical ventilation has been shown to alter renal hemodynamics by leading to an increase in intrathoracic pressure, therefore decreasing cardiac output, leading to renal vasoconstriction and decreased GFR (Arant, 1987). It is likely that changes in renal blood flow will directly influence the growth of the kidney. Hence, it is important in future research to determine the effects of altered renal hemodynamics on growth of the developing kidney and how this is influenced by different modes of ventilation.
