title: Incidence, Characteristics and Risk Factors of Acute Kidney Injury among Dengue Patients: A Retrospective Analysis.
abstract: BACKGROUND
  Dengue induced acute kidney injury (AKI) imposes heavy burden of illness in terms of morbidity and mortality. A retrospective study was conducted to investigate incidence, characteristics, risk factors and clinical outcomes of AKI among dengue patients.
  
  
  METHODS
  A total 667 dengue patients (2008-2013) were retrospectively evaluated and were stratified into AKI and non-AKI groups by using AKIN criteria. Two groups were compared by using appropriate statistical methods.
  
  
  RESULTS
  There were 95 patients (14.2%) who had AKI, with AKIN-I, AKIN-II and AKIN-III in 76.8%, 16.8% and 6.4% patients, respectively. Significant differences (P<0.05) in demographics and clinico-laboratory characteristics were observed between patients with and without AKI. Presence of dengue hemorrhagic fever [OR (95% CI): 8.0 (3.64–17.59), P<0.001],rhabdomyolysis [OR (95% CI): 7.9 (3.04–20.49)], multiple organ dysfunction OR (95% CI):17.9 (9.14–35.12), P<0.001], diabetes mellitus [OR (95% CI): 4.7 (1.12–19.86), P = 0.034], late hospitalization [OR (95% CI): 2.1 (1.12–19.86), P = 0.033] and use of nephrotoxic drugs [OR(95% CI): 2.9 (1.12–19.86), P = 0.006] were associated with AKI. Longer hospital stay (>3days) was also observed among AKI patients (OR = 1.3, P = 0.044) [corrected].Additionally, 48.4% AKI patients had renal insufficiencies at discharge that were signicantly associated with severe dengue, secondary infection and diabetes mellitus. Overall mortality was 1.2% and all fatal cases had AKI.
  
  
  CONCLUSIONS
  The incidence of AKI is high at 14.2% among dengue patients, and those with AKI portended significant morbidity, mortality, longer hospital stay and poor renal outcomes. Our findings suggest that AKI in dengue is likely to increase healthcare burden that underscores the need of clinicians' alertness to this highly morbid and potentially fatal complication for optimal prevention and management.
authors.affiliation: Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, University Sains Malaysia, Penang, Malaysia; Chronic Kidney Disease Resource Centre, School of Medical Sciences, Health Campus, University Sains Malaysia, Kubang Kerain, Kelantan, Malaysia.
authors.forename: Tauqeer Hussain
authors.initials: TH
authors.lastname: Mallhi
authors.affiliation: Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, University Sains Malaysia, Penang, Malaysia; Chronic Kidney Disease Resource Centre, School of Medical Sciences, Health Campus, University Sains Malaysia, Kubang Kerain, Kelantan, Malaysia.
authors.forename: Amer Hayat
authors.initials: AH
authors.lastname: Khan
authors.affiliation: Chronic Kidney Disease Resource Centre, School of Medical Sciences, Health Campus, University Sains Malaysia, Kubang Kerain, Kelantan, Malaysia.
authors.forename: Azreen Syazril
authors.initials: AS
authors.lastname: Adnan
authors.affiliation: Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, University Sains Malaysia, Penang, Malaysia.
authors.forename: Azmi
authors.initials: A
authors.lastname: Sarriff
authors.affiliation: Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, University Sains Malaysia, Penang, Malaysia; Chronic Kidney Disease Resource Centre, School of Medical Sciences, Health Campus, University Sains Malaysia, Kubang Kerain, Kelantan, Malaysia.
authors.forename: Yusra Habib
authors.initials: YH
authors.lastname: Khan
authors.affiliation: Department of Obstetrics and Gynecology, School of Medical Sciences, Health Campus, University Sains Malaysia, Kubang Kerain, Kelantan, Malaysia.
authors.forename: Fauziah
authors.initials: F
authors.lastname: Jummaat
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology* / Q000401:mortality* / Q000628:therapy; D000293:Adolescent; D000328:Adult; D003715:Dengue / Q000150:complications* / Q000401:mortality* / Q000628:therapy; D005260:Female; D006801:Humans; D015994:Incidence; D007902:Length of Stay; D008296:Malaysia / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies