title: Dialysis for acute kidney injury associated with influenza a (H1N1) infection.
abstract: In June 2009, the World Health Organization declared a novel influenza A, S-OIV (H1N1), pandemic. We observed 44 consecutive patients during the "first wave" of the pandemic. 70.5% of them showed co-morbidities (hypertension, obesity, chronic respiratory diseases, chronic renal disease, diabetes, pregnancy). Serious cases were admitted to the intensive care unit (ICU), particularly those with severe acute respiratory failure. Some of them developed acute kidney injury (AKI) and required renal replacement therapy (RRT). The average time between admission to the ICU and initiation of RRT was 3.16 ± 2.6 days. At initiation of RRT, most patients required mechanical ventilation. No relationship was found with creatinine-kinase levels. Seventy-five percent of the cases were observed during a 3-week period and mortality, related to respiratory failure, doubling of alanine amino transferase and use of inotropics was 81.8%. In conclusion, the H1N1-infected patients who developed RRT-requiring AKI, in the context of multi-organ failure, showed a high mortality rate. Thus, it is mandatory that elaborate strategies aimed at anticipating potential renal complications associated to future pandemics are implemented.
authors: Nephrology and Kidney Transplant Unit, Argerich Hospital, Junín City, Buenos Aires Province, Argentina. acvallejos@gmail.com
authors: Augusto
authors: A
authors: Vallejos
authors: Marcelo
authors: M
authors: Arias
authors: Ana
authors: A
authors: Cusumano
authors: Eduardo
authors: E
authors: Coste
authors: Miguel
authors: M
authors: Simon
authors: Ricardo
authors: R
authors: Martinez
authors: Sandra
authors: S
authors: Mendez
authors: Miguel
authors: M
authors: Raño
authors: Luis
authors: L
authors: Sintado
authors: Bruno
authors: B
authors: Lococo
authors: Carlos
authors: C
authors: Blanco
authors: Jorge
authors: J
authors: Cestari
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis / Q000453:epidemiology / Q000401:mortality / Q000628:therapy* / Q000821:virology; D000328:Adult; D001118:Argentina / Q000453:epidemiology; D016009:Chi-Square Distribution; D015897:Comorbidity; D003422:Critical Care; D005260:Female; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype / Q000472:pathogenicity*; D007251:Influenza, Human / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000821:virology*; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D058873:Pandemics; D006435:Renal Dialysis / Q000009:adverse effects / Q000401:mortality; D012121:Respiration, Artificial; D012131:Respiratory Insufficiency / Q000453:epidemiology / Q000628:therapy / Q000821:virology; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D061665:Time-to-Treatment; D016896:Treatment Outcome; D055815:Young Adult