Table 3.
Risk factors for AKI in children admitted to hospital for a vaso-occlusive crisis (sKDIGO)
| Bivariate analysis | Multivariate analysis | |||||
|---|---|---|---|---|---|---|
| No AKI (n = 118) | AKI* (n = 67) | OR (95% CI) | P value | aOR (95% CI) | P value | |
| Demographics and Clinical Characteristics | ||||||
| Age, years, median (IQR) | 8.0 95.1, 11.3) | 10 (7.3, 12.4) | 1.11 (1.03–1.20) | 0.010 | 1.10 (1.10, 1.20) | 0.022 |
| Age categories, n (%) | ||||||
| < 5 years | 28 (23.7) | 8 (11.9) | 1 (reference) | |||
| 5–10 years | 47 39.8) | 26 (38.8) | 1.94 (0.77–4.86) | 0.159 | ||
| > 10 years | 43 (36.4) | 33 (49.3) | 2.69 (1.08–6.65) | 0.033 | ||
| Sex, n (%) Female | 42 (35.6) | 35 (52.2) | 1.98 (1.08–3.64) | 0.028 | 1.74 (0.88, 3.45 | 0.110 |
| Height-for-age z score | -1.2 (-2.1, -0.3) | -1.7 (-2.6, -1.0) | 0.8 (0.64–0.99) | 0.044 | ||
| Blood pressure category, n (%) | ||||||
| Hypotensive | 1 (0.9) | 1 (1.5) | 1.81 (0.11–29.55) | 0.677 | ||
| Normotensive (reference) | 96 (81.4) | 53 (79.1) | 1 (reference) | –- | ||
| Hypertensive | 21 (17.8) | 13 (19.4) | 1.12 (0.52–2.42) | 0.770 | ||
| Diarrhea, n (%) | 1 (0.9) | 3 (4.5) | 5.48 (0.56–53.81) | 0.144 | ||
| Vomiting, n (%) | 5 (4.2) | 8 (11.9) | 3.06 (0.96–9.78) | 0.059 | ||
| Unable to drink/breastfeed, n (%) | 1 (0.9) | 7 (10.5) | 13.65 (1.64–113.52) | 0.016 | ||
| Hypovolemia (%) | 8 (6.8) | 16 (23.9) | 4.31 (1.73–10.73) | 0.002 | 2.98 (1.08, 8.23) | 0.035 |
| Severe anemia, hemoglobin < 8.0 g/dL, n (%) | 77 (65.3) | 54 (80.6) | 2.21 (1.08–4.52) | 0.029 | ||
| Splenomegaly, n (%) | 9 (7.6) | 9 (13.4) | 1.88 (0.70–4.99) | 0.208 | ||
| No hepatomegaly | 77 (65.3) | 30 (44.8) | 1 (reference) | –- | 1 (reference) | –- |
| Hepatomegaly | 24 (20.3) | 16 (23.9) | 1.71 (0.80–3.66) | 0.166 | 1.57 (0.69, 3.59) | 0.281 |
| Tender hepatomegaly | 17 (14.4) | 21 (31.3) | 3.17 (1.73–6.82) | 0.003 | 2.46 (1.05, 5.77) | 0.038 |
| History of reduced urine output, n (%) | 8 (6.8) | 7 (10.5) | 1.60 (0.55–4.63) | 0.383 | ||
| History of tea coloured urine, n (%) | 41 (34.8) | 38 (56.7) | 2.46 (1.33–4.55) | 0.004 | 1.63 (0.83, 3.22) | 0.157 |
| Laboratory Findings | ||||||
| WBC × 103/μL | 20.1 (15.4, 30.3) | 25.5 (18.2, 46.7) | 1.01 (1.002–1.026) | 0.015 | ||
| Neutrophil count × 103/μL | 11.3 (8.0, 16.2) | 14.3 (8.9, 20.4) | 1.04 (1.004–1.072) | 0.029 | ||
| Hemoglobin, g/dL | 7.4 (6.5, 8.4) | 6.9 (5.9, 7.7) | 0.79 (0.65–0.97) | 0.022 | ||
| Platelet count × 103/μL | 435 (330, 557) | 382 (265, 488) | 1.00 (1.00–1.00) | 0.079 | ||
| Sepsis, n (%) | 9 (7.6) | 10 (14.9) | 2.12 (0.82–5.52) | 0.122 | ||
| Malaria, n (%) | 7 (6.3) | 10 (15.2) | 2.65 (0.96–7.35) | 0.061 | ||
| Urinary tract infection, n (%) | 1 (0.9) | 3 (4.6) | 5.48 (0.56–53.74) | 0.145 | ||
| Acute infection, n (%) | 17 (14.4) | 21 (31.3) | 2.71 (1.31–5.62) | 0.007 | 2.63 (1.19, 5.81) | 0.017 |
| Urine ACR, n (%) | ||||||
| < 3 mg/mmol | 74 (66.7) | 31 (48.4) | 1 (reference) | –- | ||
| 3–30 mg/mmol | 31 (27.9) | 24 (37.5) | 1.85 (0.94–3.64) | 0.076 | ||
| > 30 mg/mmol | 6 (5.4) | 9 (14.1) | 3.58 (1.17–10.92) | 0.025 | ||
Variables in the multivariate analysis included age, sex, hypovolemia, hepatomegaly, reported history of tea coloured urine, and an acute infection