Abstract: SA-PO082
AKI in Hospitalizations with Sickle Cell Disease in Jamaica
Session Information
- AKI: Epidemiology, Risk Factors, Prevention - II
November 04, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Acute Kidney Injury
- 101 AKI: Epidemiology, Risk Factors, and Prevention
Authors
- Fisher, Lori- Ann M., The University of the West Indies, Kingston, Kingston, Jamaica
- Asnani, Monika, The University of the West Indies, Kingston, Kingston, Jamaica
Background
Renal disease is amongst the leading causes of mortality in persons living with sickle cell disease (SCD). We describe the epidemiology and associations of acute kidney injury (AKI) in Jamaicans hospitalized with SCD.
Methods
A retrospective cohort study of admissions with coded diagnoses of SCD between January 1, 2016 to December 31, 2019 at the University Hospital of the West Indies was performed. Exclusion criteria were age < 1 month or if less than two creatinines were available. AKI was defined using Kidney Disease improving global outcomes (KDIGO) as either an increase of at least 1.5 times baseline creatinine if known. If baseline creatinine was unavailable this was defined as an increase of 1.5 times the maximum creatinine to the lowest creatinine in the admission. The index admission for each case was analysed. Data were described using summary statistics. Differences between AKI and non-AKI groups were performed using chi-square or t-tests were appropriate. Multivariable logistic regression was used to determine associated factors with AKI.
Results
Of 144 participants, mean age 27.0 ±15.4 years, 62.2% were female and 84.5% Hemoglobin-SS genotype. One third (n=48) of participants were children (age<18 years). AKI occurred in 19.4% (n=28). The main admitting diagnoses were vaso-occulsive crises in 61.1%, Acute chest syndrome 27.8%, Lower Respiratory Tract Infection 17.4%, hepatic sequestration 13.2%. Baseline CKD was reported in 6.3%, hydroxyurea use in 4.9% and NSAID use 20.1%. Three participants were admitted to the intensive care unit. There were no in-hospital deaths. Mean duration of hospitalization was 8.8±8.3 days(range:1-59 days). A quarter of patients (26.4%) had red blood cell (RBC) transfusion, exchange transfusion was performed in 2 children. Compared to no AKI, AKI participants were older (mean age 32.1 ±14.9 versus 25.8 ±15.4 years, p=0.05), with a higher proportion receiving RBC transfusion (46% versus 21.6%, p=0.007). Based on a logistic regression model adjusting for age and sex, RBC transfusion was associated with AKI in adults (OR 3.1 95% CI: 1.1-8.6, p=0.003), but not children (OR: 0.5 95%CI 0.04-6.5, p=0.612). There was no difference in length of hospital stay in AKI and non AKI groups.
Conclusion
AKI frequently complicates admissions with sickle cell disease. Further studies determining long-term outcomes following AKI events are needed.