title: Impact of renal failure on the outcome of dengue viral infection.
abstract: OBJECTIVE
  In the 2002 dengue outbreak in Taiwan, some fatal cases had the underlying disease of renal failure (RF). Physicians faced difficulty in diagnosis and treatment of these patients; however, the impacts of RF on the clinical presentations and outcomes of dengue infection have not been reported previously.
  
  
  METHODS
  A retrospective review was conducted of medical records, clinical presentations, laboratory findings, and underlying diseases for all cases of dengue infection in a medical center. Characteristics and outcomes of dengue-infected patients with and without RF were compared.
  
  
  RESULTS
  From January 2002 through January 2003, 519 dengue-infected patients were enrolled, including 412 patients with classical dengue fever (DF) and 107 patients with dengue hemorrhagic fever (DHF)/dengue shock syndrome (DSS). Twelve patients died in this outbreak, and all had DHF/DSS. Twenty-one (4.0%) patients were defined as being in the RF group. The RF group had a higher mortality rate than non-RF group (28.6 versus 1.2%; P < 0.001). The severity of GFR impairment was associated with higher percentages of DHF/DSS (P = 0.029) and mortality (P < 0.001). Differences in symptoms/signs and laboratory abnormalities between DF and DHF/DSS were significant in the non-RF group but not apparent in the RF group.
  
  
  CONCLUSIONS
  The diagnosis and management of dengue infection among patients with RF must be cautious, because complicated clinical courses with a higher mortality rate were well observed.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Taiwan.
authors.forename: Mei-Chuan
authors.initials: MC
authors.lastname: Kuo
authors.forename: Po-Liang
authors.initials: PL
authors.lastname: Lu
authors.forename: Jer-Ming
authors.initials: JM
authors.lastname: Chang
authors.forename: Ming-Yen
authors.initials: MY
authors.lastname: Lin
authors.forename: Jih-Jin
authors.initials: JJ
authors.lastname: Tsai
authors.forename: Yen-Hsu
authors.initials: YH
authors.lastname: Chen
authors.forename: Ko
authors.initials: K
authors.lastname: Chang
authors.forename: Hung-Chun
authors.initials: HC
authors.lastname: Chen
authors.forename: Shang-Jyh
authors.initials: SJ
authors.lastname: Hwang
mesh_terms: D000328:Adult; D003404:Creatinine / Q000097:blood; D003715:Dengue / Q000150:complications* / Q000188:drug therapy / Q000401:mortality / Q000503:physiopathology; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D017582:Renal Replacement Therapy; D012189:Retrospective Studies; D018570:Risk Assessment; D019595:Severe Dengue / Q000150:complications* / Q000188:drug therapy / Q000401:mortality / Q000503:physiopathology; D012720:Severity of Illness Index; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D003404:Creatinine