Background: India has the largest number of preterm births in the world, roughly 3 million a year, and about one in six newborns is born with low birth weight (LBW). Preterm birth and LBW reduce nephron endowment and roughly double the lifetime risk of chronic kidney disease (CKD). Yet structured kidney follow-up of neonatal intensive care unit (NICU) and special newborn care unit (SNCU) graduates is rare in India, and no risk stratification tool exists for this population. Aim: To review the evidence linking preterm birth and LBW to CKD, describe the Indian care pathway for at-risk infants, draw on recent clinician-perspective research on clinical decision support (CDS) tools, and propose an India-adapted framework for CKD risk prediction in children. Key points: (1) Risk factors that can be captured at NICU/SNCU discharge — gestational age, birth weight, small-for-gestational-age status, neonatal acute kidney injury, nephrotoxic drug exposure, and congenital anomalies of the kidney and urinary tract (CAKUT) — allow simple tiered risk stratification. (2) International data show clinicians want CDS tools that fit workflow, integrate with records and give actionable advice with family education. (3) In India, paper-based discharge summaries, the Mother and Child Protection Card, Rashtriya Bal Swasthya Karyakram (RBSK) and the Ayushman Bharat Digital Mission (ABDM) offer practical delivery routes. (4) Low-cost tests — blood pressure, urine dipstick for protein, serum creatinine with bedside Schwartz eGFR — suit resource-limited follow-up. (5) Over-referral to scarce paediatric nephrologists and false reassurance must be designed against. Conclusion: A tiered, low-cost, family-centred CKD risk tool for children born preterm or LBW is feasible in India and is needed. We outline a research agenda, starting with a multi-stakeholder qualitative study of Indian clinicians and families.