THE RISK OF DEVELOPING ACUTE KIDNEY INJURY AMONG SICKLE CELL DISEASE PATIENT DURING CRISIS: A RETROSPECTIVE STUDY IN A SINGLE TERTIARY CENTER AT JEDDAH, SAUDI ARABIA

Abstract

Background: Sickle cell disease (SCD) is a common inherited hemoglobinopathy. Acute kidney injury (AKI) is a serious complication of SCD, often precipitated by crises, dehydration, or nephrotoxic exposure. Data on AKI prevalence in SCD patients in Saudi Arabia remain limited.

Objectives: To determine the prevalence and risk factors of AKI among SCD patients presenting with crises at King Abdulaziz University Hospital, Jeddah.

Design: Retrospective cohort study.

Setting: King Abdulaziz University Hospital, Jeddah, Saudi Arabia.

Patients and Methods: Medical records of patients aged ≥15 years admitted with SCD crises between January 2016 and December 2022 were reviewed. Demographics, comorbidities, medications, crisis type, and laboratory parameters were collected. AKI was defined according to kidney Disease: Improving Global Outcomes (KDIGO) criteria. Statistical analyses included t-test, ANOVA, chi-square, and correlations, with p<0.05 considered significant.

Main Outcome Measures: Prevalence of AKI and its association with demographic, clinical, and laboratory variables.

Sample Size: A total of 354 admissions were screened; 183 patients met the inclusion criteria.

Results: The mean age was 30 years, and 51% were female. VOC was the predominant crisis type (91%). AKI occurred in 15% of patients (n=27), most commonly within the first day of admission (67%). Significant predictors of AKI included higher BMI (p=0.001), history of prior AKI (p=0.017), hemoglobin reduction during admission (p=0.044), and creatinine dynamics (p=0.001–0.014). Fever was significantly associated with both crisis triggers (p<0.001) and urine culture positivity (p=0.001). No significant association was observed between AKI and use of analgesics, NSAIDs, hydroxyurea, or SCD-modifying therapies. The mean hospital stay was 7 days.

Conclusions: AKI occurred in 15% of SCD patients during crises, with early presentation in most cases. BMI, prior renal events, hemoglobin decline, and creatinine trends were significant predictors, highlighting the need for early renal monitoring and preventive strategies.