Renal Function In Dengue Fever And Its Correlation With Disease Severity- A Retrospective Observational Study In A Tertiary Centre
Keywords:
dengue, acute kidney injury, proteinuria, hyponatremiaAbstract
Background: The renal manifestations of dengue are less understood and often ignored. Limited data is available from our geographical location to estimate the prevalence of renal dysfunction & its impact on duration of hospitalization and mortality among dengue patients with varied severity. We intend to address this lacuna.
Methods: Retrospective observational cross-sectional study including 120 patients with confirmed dengue serology admitted in Medicine Department of Father Muller Medical College and Hospital during November 2018-December 2019. We compared data including Renal function test, Liver function test, urinalysis, duration of hospital stay, and condition at discharge among patients with AKI group and non-AKI group.
Results: Acute kidney injury was significantly higher in severe dengue (SDG) patients (41.7%) compared to patients with dengue without warning signs (DWWS) and dengue with warning signs (DWS). Dengue warning signs such as reduced urine output, fluid accumulation, respiratory distress due to fluid accumulation, shock, Acute respiratory distress syndrome (ARDS), another organ failure, impaired consciousness and elevated Serum glutamic oxaloacetic transaminase (SGOT)/Serum glutamic pyruvic transaminase (SGPT) >1000 were all significantly higher in the AKI group compared to non-AKI group. Moderate hyponatremia was seen in 10.6%, 14.3% and 25% patients with DWWS, DWS and SDG respectively. Severe hypokalemia was seen in 10.6%, 4.7% and 20% patients with DWWS, DWS and SDG respectively. Proteinuria and hematuria were significantly high in SDG. Patients with AKI had persistent thrombocytopenia (35.7%) and poor outcome with 7.1% mortality.
Conclusion: Prevalence of AKI in our study was 11.7%. Renal dysfunction in dengue varies from asymptomatic urinary abnormalities to AKI, later is more commonly seen in severe dengue. Hepatic involvement in the form of with elevated transaminases and bilirubin were commonly seen in our patients with AKI. Dengue patients with AKI had persistent thrombocytopenia and poor outcomes with higher mortality rate.
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