title: Scrub typhus associated acute kidney injury--a study from a tertiary care hospital from western Himalayan State of India.
abstract: OBJECTIVE
  To report the clinical profile of acute kidney injury (AKI) associated with scrub typhus.
  
  
  METHODS
  Retrospective study of hospitalized patients of acute febrile illness who were diagnosed scrub typhus and had AKI.
  
  
  RESULTS
  174 (35%) patients (75.9% female), mean age (41.4 ± 15.9 years) were studied. The laboratory abnormalities were: anemia (63.2%), leukocytosis (44.3%), thrombocytopenia (61.5%), hyponatremia (35.6%), hypernatremia (2.9%), and hypokalemia (12.1%), hyperkalemia (11.5%), hypoalbuminemia (56.9%), hepatic dysfunction (70%) and metabolic acidosis (28.7%). The complications of hypotension (5.7%), septic shock (3.4%), pneumonia (10.9%), acute respiratory distress syndrome (ARDS) (11.5%), meningoencephalitis (6.9%), encephalopathy (5.2%), gastrointestinal bleed (1.3%), myocarditis (3.4%), disseminated intravascular coagulation (2.9%) and multi organ failure (MOF) (10.3%) developed during course of hospitalization in these patients. Twenty-five (14.4%) patients required intensive care support (ICU) support and seven (4%) patients were dialyzed. 146 (83.9%) patients survived. Twenty-eight (16.1%) patients died. There was a significant difference in the age, various hematological & biochemical abnormalities, complications and need for ICU support in the non-survival group as compared the survival group.
  
  
  CONCLUSIONS
  This study shows that AKI in scrub typhus is common and a severe disease. Age, a shorter hospital stay, severities of leukocytosis, thrombocytopenia, azotemia, hypoalbuminemia, hepatic dysfunction and the complications of ARDS, encephalopathy, MOF and need for ICU support are the factors associated with mortality.
authors: Department of Nephrology .
authors: Sanjay
authors: S
authors: Vikrant
authors: Santosh Kumar
authors: SK
authors: Dheer
authors: Anupam
authors: A
authors: Parashar
authors: Dalip
authors: D
authors: Gupta
authors: Surinder
authors: S
authors: Thakur
authors: Ashok
authors: A
authors: Sharma
authors: Satinder Singh
authors: SS
authors: Kaushal
authors: Anil
authors: A
authors: Kanga
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood / Q000382:microbiology* / Q000401:mortality; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012612:Scrub Typhus / Q000097:blood / Q000150:complications*; D062606:Tertiary Care Centers / Q000706:statistics & numerical data; D055815:Young Adult