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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
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