title: Acute kidney injury in dengue fever using Acute Kidney Injury Network criteria: incidence and risk factors.
abstract: The aim of this study was to assess incidence and risk factors for acute kidney injury (AKI) in patients with dengue fever (DF). A total of 223 patients (males, 130; females, 93; mean age, 26.2 ± 18.2 years) from a tertiary care centre in southern India were retrospectively analysed. Acute renal failure (ARF) developed in 24 (10.8%) patients. Based on the Acute Kidney Injury Network (AKIN) criteria, the results revealed that: 12 (5.4%) had mild AKI; seven (3.1%) had moderate AKI; and five (2.2%) had severe AKI. A further 54 (24%) were diagnosed with dengue haemorrhagic fever (DHF); 11 (5%) were co-infected with leptospirosis; thrombocytopenia was present in 157 (70%); and 64 (29%) were hypotensive. Patients were divided into either group A (with AKI) or group B (without AKI), and group A was divided into mild (A1), moderate (A2) and severe (A3) subgroups. We recorded: a higher total white count (A = 9824; B = 6706; P = 0.01); serum glutamic pyruvic transaminase (SGPT; A = 450; B = 144; P = 0.001); alkaline phosphatase (ALP) levels (A = 207; B = 42; P = 0.001); lower albumin (A = 2.65; B = 3.09; P < 0.001); and serum bicarbonate (A = 20.57; B = 23.21; P = 0.009). Hypotension (P = 0.01), coexisting viral hepatitis (P < 0.001), sepsis (P < 0.001), multiple organ dysfunction syndrome (MODS; P < 0.001) and the need for inotropes (P < 0.001) were associated with DF. Total white count (P = 0.038), glomerular filtration rate (GFR) on discharge (P = 0.034), specific gravity of urine (P = 0.006), ALP (P = 0.013), SGPT (P = 0.042), MODS (P = 0.05) and use of platelet fresh frozen plasma (FFP; P = 0.007) were significantly different between mild, moderate and severe AKI subgroups. Twenty-two (9%) died. AKI is associated with an increased mortality in DF (P = 0.005).
authors.affiliation: Sri Ramachandra University, Chennai, India.
authors.forename: Nikita
authors.initials: N
authors.lastname: Mehra
authors.forename: Amish
authors.initials: A
authors.lastname: Patel
authors.forename: Georgi
authors.initials: G
authors.lastname: Abraham
authors.forename: Yogesh N V
authors.initials: YN
authors.lastname: Reddy
authors.forename: Yuvaram N V
authors.initials: YN
authors.lastname: Reddy
mesh_terms: D058186:Acute Kidney Injury / Q000453:epidemiology* / Q000401:mortality / Q000503:physiopathology*; D000293:Adolescent; D000328:Adult; D002648:Child; D003715:Dengue / Q000150:complications* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D008297:Male; D012307:Risk Factors; D019595:Severe Dengue / Q000150:complications* / Q000453:epidemiology*; D012720:Severity of Illness Index; D062606:Tertiary Care Centers / Q000706:statistics & numerical data; D063128:Tertiary Health Care; D055815:Young Adult