Clinical characteristics of acute kidney injury in patients with scrub typhus--RIFLE criteria validation.
There are limited data available on the validity of the RIFLE classification for AKI in patients with scrub typhus. We investigated the incidence and clinical characteristics of scrub typhus associated AKI using the RIFLE criteria. From 2010 to 2012, 238 patients were diagnosed with scrub typhus. Of these, we included 223 patients who were followed up until renal recovery or for at least three months. We evaluated the incidence, clinical characteristics, and severity of AKI based on the RIFLE classification. Of the 223 patients, 47 (21%) had scrub typhus-associated AKI. The incidence of AKI was 21.1%; of which, 10.7%, 9.4% and 1% were classified as Risk, Injury and Failure, respectively. In comparison with patients in the non-AKI group, the patients in the AKI group were older (70 ± 9 vs 61 ± 14 year, P = 0.01) and had one or more comorbidities such as hypertension, diabetes, and chronic kidney disease (77% vs 22%, p = 0.01). In the AKI group, forty-four patients had AKI prior to admission, and three patients experienced AKI during their hospitalization. By multivariate logistic regression analysis, age and comorbidity were significant predictors of AKI. All patients recovered baseline renal function without renal replacement therapy following antibiotics therapy and supportive care. The incidence of AKI in patient with scrub typhus is 21%. Age and co-morbidity are significant predictors of AKI in scrub typhus. In cases of scrub typhus-associated AKI, anti-rickettsia agent and supportive care are very important.
Division of Nephrology, Department of Internal Medicine, Presbyterian Medical Center, 300 Junghwasan-Dong, Wansan-Ku, Jeonju, Republic of Korea.
In O
IO
Sun
Division of Nephrology, Department of Internal Medicine, Presbyterian Medical Center, 300 Junghwasan-Dong, Wansan-Ku, Jeonju, Republic of Korea.
Moon Chul
MC
Kim
Division of Nephrology, Department of Internal Medicine, Presbyterian Medical Center, 300 Junghwasan-Dong, Wansan-Ku, Jeonju, Republic of Korea.
Jae Woo
JW
Park
Division of Nephrology, Department of Internal Medicine, Presbyterian Medical Center, 300 Junghwasan-Dong, Wansan-Ku, Jeonju, Republic of Korea.
Min A
MA
Yang
Division of Nephrology, Department of Internal Medicine, Presbyterian Medical Center, 300 Junghwasan-Dong, Wansan-Ku, Jeonju, Republic of Korea.
Cheon Beom
CB
Lee
Division of Nephrology, Department of Internal Medicine, Presbyterian Medical Center, 300 Junghwasan-Dong, Wansan-Ku, Jeonju, Republic of Korea.
Hyun Ju
HJ
Yoon
Division of Nephrology, Department of Internal Medicine, Presbyterian Medical Center, 300 Junghwasan-Dong, Wansan-Ku, Jeonju, Republic of Korea.
Jeong Gwan
JG
Kim
Division of Nephrology, Department of Internal Medicine, Presbyterian Medical Center, 300 Junghwasan-Dong, Wansan-Ku, Jeonju, Republic of Korea. Electronic address: kwangpmc@hanmail.net.
Kwang Young
KY
Lee
D058186:Acute Kidney Injury / Q000382:microbiology* / Q000503:physiopathology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D063305:Organ Dysfunction Scores; D012612:Scrub Typhus / Q000150:complications* / Q000503:physiopathology; D055815:Young Adult
Acute kidney injury; RIFLE; Scrub typhus