Table 5.
Associations of medications and types of institutions with early AKI in the full Assessment of Worldwide AKI Epidemiology in Neonates cohort
| Variable | Non-AKI (%) | AKI (%) | Partially Adjusteda OR (95% CI) | P Value | Fully Adjustedb OR (95% CI) | P Value |
|---|---|---|---|---|---|---|
| Antimicrobial medicationsc | ||||||
| No | 403 (24) | 254 (57) | Ref | — | Ref | — |
| Yes | 1258 (74) | 195 (43) | 0.2 (0.2 to 0.3) | <0.001 | 0.3 (0.2 to 0.3) | <0.001 |
| Methylxanthinesc | ||||||
| No | 1194 (72) | 389 (87) | Ref | — | Ref | — |
| Yes | 467 (28) | 60 (13) | 0.3 (0.2 to 0.5) | <0.001 | 0.4 (0.3 to 0.6) | <0.001 |
| Diureticsc | ||||||
| No | 1591 (96) | 434 (97) | Ref | — | Ref | — |
| Yes | 70 (4) | 115 (3) | 0.6 (0.4 to 1.1) | 0.12 | 0.5 (0.3 to 1.0) | 0.04 |
| Vasopressorsc | ||||||
| No | 1521 (92) | 411 (92) | Ref | — | Ref | — |
| Yes | 140 (8) | 38 (9) | 0.7 (0.5 to 1.1) | 0.11 | 0.6 (0.4 to 0.9) | 0.01 |
| NSAIDsc | ||||||
| No | 1584 (95) | 436 (97) | Ref | — | Ref | — |
| Yes | 77 (5) | 13 (3) | 0.6 (0.2 to 1.5) | 0.25 | 0.8 (0.3 to 2.2) | 0.62 |
| Mean serum creatinine measurements | 3±3 | 5±4 | 1.2 (1.1 to 1.3) | <0.001 | 1.2 (1.1 to 1.3) | <0.001 |
| Site type | ||||||
| Children’s hospital | 422 (25) | 255 (57) | 3.8 (2.2 to 6.6) | <0.001 | 2.8 (1.6 to 5.0) | 0.001 |
| Perinatal | 307 (19) | 56 (13) | ||||
| Perinatal/surgical | 932 (56) | 138 (31) | Ref | — | Ref | — |
| Creatinine method | ||||||
| Enzymatic | 1250 (77) | 324 (76) | Ref | — | Ref | — |
| Jaffe | 368 (23) | 105 (25) | 1.0 (0.5 to 2.3) | 0.91 | 1.0 (0.6 to 1.7) | >0.99 |
| Sites outside of the USA | 217 (13) | 43 (10) | 0.6 (0.3 to 1.3) | 0.20 | 1.0 (0.5 to 1.8) | 0.89 |
Antimicrobial medications: acyclovir, amphotericin B, aminoglycosides, piperacillin-tazobactam, and vancomycin; methylxanthine medications: caffeine and theophylline; diuretic medications: bumetanide, chlorothiazide, furosemide, and spironolactone; vasopressor medications: dobutamine, epinephrine, milrinone, NE, and dopamine; and NSAID medications: indomethacin and ibuprofen. OR, odds ratio; 95% CI, 95% confidence interval; Ref, XXX; —, XXX; NSAIDs, nonsteroidal anti-inflammatory drugs.
Estimated from a generalized estimating equation (GEE) logistic model accounting for clustering by study center and adjusted for gestational age, ethnicity, and Apgar-1 and 5.
Estimated from a GEE logistic model accounting for clustering by study center and adjusted for gestational age, ethnicity, and Apgar-1 and 5 in addition to other variables in the table.
All medications were given before the episode of AKI.