title: Acute kidney injury in tropical acute febrile illness in a tertiary care centre--RIFLE criteria validation.
abstract: BACKGROUND
  Acute febrile illnesses are a common cause of tropical acute kidney injury (AKI). The incidence and severity of AKI in tropical febrile illnesses and validity of RIFLE classification are unclear.
  
  
  METHODS
  Consecutive adult inpatients of a tertiary hospital in southern India with tropical acute febrile illness between January 2007 and January 2008 were prospectively studied for the incidence and severity of AKI based on RIFLE classification and its association with mortality and dialysis requirement.
  
  
  RESULTS
  The 367 patients (mean age 39.7±16.9 years; 60% males) with tropical acute febrile illness due to scrub typhus (51.2%), falciparum malaria (10.4%), enteric fever (8.7%), dengue (7.6%), mixed malaria (6.5%), leptospirosis (3.3%), undifferentiated acute febrile illness (8.4%) and others (3.8%) (spotted fever, vivax malaria and Hantaan virus infection) had an overall mortality rate of 12.3%. The incidence of AKI was 41.1%; of which, 17.4%, 9.3% and 14.4% were in the Risk, Injury and Failure classes, respectively. Of the patients, 7.9% required dialysis. Among the Risk, Injury and Failure groups, there was an incremental risk of mortality (OR 6.9, 20.2 and 25.6; P<0.001) and dialysis requirement (OR 3.4, 28.8 and 178.8; P<0.001).
  
  
  CONCLUSIONS
  The incidence of AKI in the common tropical acute febrile illnesses in our study such as scrub typhus, falciparum malaria, enteric fever, dengue and leptospirosis is 41.1%. RIFLE classification is valid and applicable in AKI related to tropical acute febrile illnesses, with an incremental risk of mortality and dialysis requirement.
authors: Department of Nephrology, Christian Medical College, Vellore, India.
authors: Gopal
authors: G
authors: Basu
authors: Anugrah
authors: A
authors: Chrispal
authors: Harikishan
authors: H
authors: Boorugu
authors: Kango G
authors: KG
authors: Gopinath
authors: Sara
authors: S
authors: Chandy
authors: John Anthony Jude
authors: JA
authors: Prakash
authors: Kurien
authors: K
authors: Thomas
authors: Asha M
authors: AM
authors: Abraham
authors: George T
authors: GT
authors: John
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality / Q000628:therapy; D000328:Adult; D005334:Fever / Q000209:etiology*; D006801:Humans; D015994:Incidence; D007194:India; D007239:Infections / Q000150:complications; D010272:Parasitic Diseases / Q000150:complications; D006435:Renal Dialysis; D012720:Severity of Illness Index