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Table 3 Measures associated with acute kidney injury

From: Acute kidney injury is associated with impaired cognition and chronic kidney disease in a prospective cohort of children with severe malaria

 

Severe malarial anemia (n = 219)

Cerebral malaria (n = 260)

No AKI (n = 164)

AKI (n = 55)

p value

No AKI (n = 147)

AKI (n = 113)

p value

Demographics

 Age, years

2.8 (2.1, 4.2)

3.2 (2.0, 4.9)

0.375

3.6 (2.7, 5.4)

3.2 (2.2, 4.5)

0.014

 Sex, F %

65 (39.6)

21 (38.2)

0.849

59 (40.1)

48 (42.3)

0.705

 Weight-for-age z score

− 1.5 (− 2.2, − 0.7)

− 1.8 (− 2.4, − 0.6)

0.439

− 1.0 (− 1.8, − 0.4)

− 1.4 (− 1.9, − 0.8)

0.044

 Height-for-age z score

− 1.0 (− 1.8, − 0.3)

− 1.4 (− 2.6, − 0.5)

0.119

− 0.7 (− 1.3, 0.3)

− 1.0 (− 1.9, − 0.1)

0.024

 Weight-for-height z score

− 0.9 (− 1.8, − 0.1)

− 0.9 (− 1.6, − 0.1)

0.697

− 1.0 (− 1.8, − 0.1)

− 1.0 (− 1.7, − 0.3)

0.914

 HIV-infected, n (%)

5 (3.1)

1 (1.9)

1.000

1 (0.7)

4 (4.0)

0.165

 Sickle cell disease (HbSS), n (%)

17 (10.4)

4 (7.3)

0.605

1 (0.7)

0 (0.0)

0.380

Admission characteristics

 Symptoms

  History of fever, days

4 (3, 5)

3 (2, 5)

0.078

3 (2, 4)

3 (2, 4)

0.537

  Tea-colored urine, n (%)

23 (14.0)

15 (27.3)

0.025

18 (12.2)

27 (23.9)

0.014

  Diarrhea, n (%)

10 (6.1)

6 (10.9)

0.235

6 (4.1)

6 (5.3)

0.640

  Vomiting, n (%)

74 (45.1)

38 (69.1)

0.002

60 (40.8)

38 (33.6)

0.236

 Clinical signs

  Temperature, °C

37.7 (37.0, 38.5)

37.7 (36.7, 38.5)

0.976

38.0 (36.9, 38.5)

37.6 (37.0, 38.5)

0.161

  Pulse, beats/min

150 (137, 162)

154 (138, 168)

0.158

148 (128, 165)

150 (135, 168)

0.278

  Respiratory rate, breaths/min

44 (36, 55)

40 (35, 52)

0.358

44 (34, 54)

44 (36, 56)

0.357

  Systolic blood pressure, mmHg

90 (82, 100)

90 (85, 100)

0.708

96 (90, 105)

96 (85, 104)

0.409

  Blantyre coma score

5 (5, 5)

5 (5, 5)

–

2 (1, 2)

2 (1, 2)

0.684

  Glasgow coma score

15 (15, 15)

15 (15, 15)

–

7 (6, 8)

7 (6, 8)

0.760

  Severe dehydration, n (%)1

4 (2.4)

3 (5.5)

0.371

4 (2.7)

3 (2.7)

1.000

  Urine hemoglobin positive, n (%)

10 (7.7)

8 (19.5)

0.032

14 (10.8)

28 (33.7)

< 0.0001

  Hemoglobinuria, n (%)

16 (9.8)

13 (23.6)

0.009

10 (6.9)

21 (18.6)

0.004

Laboratory tests

 Hemoglobin, g/dL

4.0 (3.1, 4.6)

3.8 (3.4, 4.3)

0.942

7.2 (5.7, 9.0)

6.0 (4.8, 7.9)

0.0002

 Glucose, mmol/L

6.8 (5.0, 8.2)

5.3 (4.1, 7.2)

0.002

6.9 (5.4, 9.6)

6.1 (4.6, 4.6)

0.032

 Lactate, mmol/L

4.6 (2.8, 7.7)

5.5 (3.6, 9.5)

0.052

3.3 (2.0, 6.1)

4.3 (2.8, 8.0)

0.003

 WBC, × 103/μL

11.2 (8.2, 15.7)

12.3 (9.2, 22.3)

0.117

8.3 (6.3, 12.3)

10.8 (7.9, 17.4)

0.0008

 Platelet, × 103/μL

155 (95, 242)

133 (82, 197)

0.179

62 (35, 112)

51 (33, 109)

0.225

 Total bilirubin, mg/dL

1.1 (0.6, 1.9)

1.5 (0.9, 2.9)

0.007

1.4 (0.8, 2.0)

2.0 (1.0, 3.6)

0.0001

 Lactate dehydrogenase (LDH), U/L

728 (591, 879)

990 (754, 1510)

< 0.00001

712 (537, 906)

1090 (797, 1513)

< 0.00001

 Plasma albumin, g/dL

2.6 (2.4, 3.0)

2.6 (2.3, 3.2)

0.737

2.6 (2.3, 3.0)

2.7 (2.4, 2.9)

0.467

 Sodium, mmol/L

134 (132, 136)

135 (132, 137)

0.383

132 (128, 135)

133 (129, 136)

0.180

 Peripheral parasite density, parasites/uL

34,680 (10,435, 133,980)

40,070 (6085, 138,470)

0.868

50,820 (13,910, 287,835)

42,140 (8000, 249,560)

0.338

 Plasma PfHRP2, ng/mL

886 (326, 2344)

1415 (382, 3453)

0.151

2244 (655, 3965)

4394 (2208, 7469)

< 0.00001

 Creatinine, mg/dL

0.31 (0.26, 0.38)

0.53 (0.48, 0.67)

< 0.00001

0.33 (0.29, 0.39)

0.58 (0.49, 0.78)

< 0.00001

 BUN, mg/dL

11 (8, 16)

22 (15, 30)

< 0.00001

13 (10, 17)

26 (18, 41)

< 0.00001

Composite disease severity score

 Number of severity criteria2

3 (2, 3)

3 (2, 4)

0.0029

4 (3, 4)

4 (3, 5)

0.0004

Nephrotoxic medication history3

 NSAIDs4

12 (7.3)

3 (5.5)

0.224

15 (10.2)

15 (13.3)

0.442

 Gentamicin

2 (1.2)

1 (1.8)

1.000

5 (3.4)

5 (4.4)

0.671

 Any nephrotoxic medication5

14 (8.5)

4 (7.3)

1.000

19 (12.9)

19 (16.8)

0.379

Number of nephrotoxic medications6

 0

148 (91.4)

50 (92.6)

0.835

127 (87.6)

98 (82.9)

0.569

 1

13 (8.0)

4 (7.4)

 

17 (11.7)

18 (16.2)

 2

1 (0.6)

0 (0.0)

 

1 (0.7)

1 (0.9)

  1. Continuous measures presented as median (interquartile range) unless otherwise indicated. Continuous measures compared using the Wilcoxon rank-sum test. Count measures compared using the Pearson’s chi-square or Fisher’s exact, as appropriate
  2. 1Severe dehydration (n = 14) was identified by the presence of sunken eyes (n = 12) or decreased skin turgor (n = 4), hemoglobinuria defined as tea-colored urine on microscopy without red blood cells
  3. 2Number of WHO criteria for severe malaria present (description in Additional file 1: Table S1)
  4. 3AKI was retrospectively assessed on stored blood samples, and data on AKI was not available on admission
  5. 4Non-steroidal anti-inflammatory drug (NSAID), included ibuprofen (n = 5), acetylsalicylic acid (n = 5), and diclophenac (n = 35)
  6. 5NSAID or gentamicin
  7. 6Sum of ibuprofen, acetylsalicylic acid, diclophenac, and gentamicin