title: Factors predicting kidney damage in Puumala virus infected patients in Southern Denmark.
abstract: In Europe, infections with Puumala hantavirus cause nephropathia epidemica. Presently the risk factors predicting severe kidney damage after Puumala virus infection are not well known. The objective of the study was to investigate environmental and individual factors predicting severe kidney damage caused by serologically established Puumala infections. In a nationwide cohort study we investigated all serologically established Puumala infections in Southern Denmark from 1996 to 2012. A total of 184 patients had serologically verified Puumala virus infection. In patients with Puumala virus infections the decrease of platelet counts preceded acute kidney failure. Multivariable logistic regression demonstrated that recent activities in the forest, platelet counts, and flu-like symptoms predicted estimated glomerular filtration rates less than 30 mL/min/1.73 m(²), but not age, gender, fever, nor abdominal pain. Severe kidney damage in Puumala infections in Southern Denmark is associated with the risk of recent activities in the forest.
authors.affiliation: Clinical Center of Emerging and Vectorborne Infections, Department of Infectious Diseases, Odense University Hospital, Odense, Denmark.|Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.
authors.forename: S
authors.initials: S
authors.lastname: Skarphedinsson
authors.affiliation: Department of Nephrology, Odense University Hospital, Odense, Denmark.|Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark.
authors.forename: H C
authors.initials: HC
authors.lastname: Thiesson
authors.affiliation: Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark.
authors.forename: S A
authors.initials: SA
authors.lastname: Shakar
authors.affiliation: Department of Nephrology, Odense University Hospital, Odense, Denmark. mtepel@health.sdu.dk.|Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark. mtepel@health.sdu.dk.|Institute for Molecular Medicine, Cardiovascular and Renal Research, Institute of Clinical Research, Odense University Hospital and University of Southern Denmark, Winsløwparken 21.3, 5000, Odense C, Denmark. mtepel@health.sdu.dk.
authors.forename: M
authors.initials: M
authors.lastname: Tepel
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood* / Q000209:etiology*; D000328:Adult; D015331:Cohort Studies; D003718:Denmark; D005260:Female; D006480:Hemorrhagic Fever with Renal Syndrome / Q000097:blood* / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D011237:Predictive Value of Tests; D029262:Puumala virus; D012307:Risk Factors