Abstract
Background: Dengue fever is a mosquito borne viral illness that has endangered a vast population of tropical and sub-tropical areas. Dengue has multi-system involvement including liver, hematological, respiratory and central nervous systems. Spectrum of renal disorders is least studied in dengue infection and its presence in dengue may be linked to increased morbidity and mortality. Objective: Tofind the frequency of acute kidney injury (AKI), its stages of severity and to compare the frequency of mortality and morbidity in various stages of AKI among dengue patients.Study type,settings& duration:This retrospective cross sectional analysis was carried out at Nephrology Department, Multan Institute of Kidney Diseases, Multan from May to October 2019.Methodology:Data of ninety patients was retrieved from hospital medical record system through non-probability consecutive sampling technique. Male and female patients of 15-50 years age with dengue virus infection were included in the study as per operational definition. Patients diagnosed with chronic kidney disease (CKD) and diabetes mellitus on the basis of history and medical record were excluded. Record of serum creatinine done at the time of admission, 48 hours later and seven days after hospital admission was taken. Presence and severity of AKI were classified according to acute kidney injury network (AKIN) criteria into stage-I, stage-Iand stage-IIIAKI. Outcome was categorized as morbidity of patients having persistent renal dysfunction manifested by serum creatinine > 1 mg/dl assessed 7 days after admission and number of patients who died within 7 days of hospital admission. SPSS 16.0 version was used for statistical analysis of this data.Results:Out of 90 patients, 19 (21.1%) developed AKI. Out of them 10 (52.6%) patients had stage I, 8 (42.1%) had stage II and 1 (5.3%) had stage III AKI. After 7 days, the mean serum creatinine of 19 patients was 1.36±0.56 mg/dl. Out of 19 patients, 11 showed outcome i.e. 7 (63.6%) had morbidity (persistent AKI) while 4 (36.4%) had mortality (died). In patients with stage I AKI, 2 (100%) had morbidity. In patients with stage II AKI, 5 (62.5%) had morbidity while 3 (37.5%) had mortality. In patients with stage III AKI, 1 (100%) had mortality. SPSS 16.0 version was used for statistical analysis of this data.Conclusion:Frequency of AKI is although low but not negligible and among these patients, complications are high. This warrants implementation of screening of renal functions in dengue fever patients in future. This practice can help us in early diagnosis of AKI and we can adopt measures to reduce morbidity and mortality associated with AKI among dengue fever patients.
Muhammad Tanzeel Abbasi, Mariam Arif, Muhammad Nabeel Abbasi, Muhammad Nauman Hashmi, Muhammad Rashid Asghar, Khuram Bashir. (2021) Severity of Acute Kidney Injury and its Effect on Outcome in Patients of Dengue Virus Infection, Pakistan Journal of Medical Research, Volume-60, Issue-2.
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