Spectrum of acute kidney injury in patients of tropical acute febrile illness in a tertiary hospital

Rohit P. Badge; V. Suresh Babu; Vinay Rathore

doi:10.18203/2320-6012.ijrms20232110

Authors

Rohit P. Badge Department of Nephrology, Yashoda Hospitals, Secunderabad, Telangana, India
V. Suresh Babu Department of Nephrology, Yashoda Hospitals, Secunderabad, Telangana, India
Vinay Rathore Department of Nephrology, AIIMS Raipur, Chhattisgarh, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20232110

Keywords:

Acute kidney injury, Leptospirosis, Tropical acute febrile illness, Dengue , Malaria

Abstract

Background: Tropical acute febrile illnesses (TAFI) such as malaria, typhoid, leptospirosis, dengue are major causes of AKI in the tropics. The spectrum of AKI due to TAFI in developing countries like India is still underestimated. Hence, we conducted a study to know the spectrum of AKI in patients of TAFI.

Methods: The prospective study was conducted in Yashoda hospital, Secunderabad a tertiary care hospital in India from April 2019 to March 2020. AKI was defined as per KDIGO. The clinical history, physical examination and laboratory investigations were recorded in a standard proforma.

Results: Hundred patients suffering from TAFI were admitted during the study period. Mean age of the study population was 43.12±14.33 years. Twenty-six (60.5%) were males. Most common presenting feature was fever (100%), chills (81.4%) and vomiting (67.4%). The most common cause of TAFI was dengue (n=49, 49%), leptospirosis (n=20, 20%), followed by malaria (n=10, 10%), scrub typhus (n=10, 10%) and undifferentiated fever (n=6, 6%). 43 patients (43%) had AKI as per KDIGO definition. 23 patients (53.5%) had stage 1, 11 (25.6%) had stage 2 and 9 (20.9%) had stage 3 AKI. RRT was required in 16.3% of patients. Dengue and leptospirosis were the most common causes for requirement of RRT. SLED was the most common modality of dialysis. Mortality was observed in 6.98% patients and Dengue was the most common cause of mortality.

Conclusions: AKI is common in tropical acute febrile illness. However, RRT was required only in 16.3% and mortality was observed in 6.98% patients.

Metrics

Metrics Loading ...

References

Bhadade R, De’Souza R, Harde MJ, Mehta KS, Bhargava P. A prospective study of acute kidney injury according to KDIGO definition and its mortality predictors. J Assoc Physicians India. 2016;64:22-8.

Basu G, Chrispal A, Boorugu H, Gopinath KG, Chandy S, Prakash JAJ, et al. Acute kidney injury in tropical acute febrile illness in a tertiary care centreRIFLE criteria validation. Nephrol Dial Transplant. 2011;26(2):524-31.

It F, Graded N, Graded N, Graded N, Ckd W. Section 2: AKI Definition Chapter 2. 1: Definition and classification of AKI. 2012;19-36.

Nair JJ. A Clinical Study of Acute Kidney Injury in Tropical Acute Febrile Illness. J Clin DiagnosticRes.2016;10(8):1-5.

Mehta K, Pajai A, Bhurke S, Shirkande A, Bhadade R, D’Souza R. Acute Kidney Injury of Infectious Etiology in Monsoon Season: A Prospective Study Using Acute Kidney Injury Network Criteria. Indian J Nephrol. 2018;28(2):143-52.

Kumar V, Kohli HS. Renal involvement in tropical infections. In: Bhalla A, eds. Association of Physicians of India Indian College of Physicians Update on Tropical Fever. Maharasthra; 2015: 50-9.

Daher EE, Marques CN, Lima RSA, Silva GB, Barbosa AS, Barbosa ES, et al. Acute kidney injury in an infectious disease intensive care unit - An assessment of prognostic factors. Swiss Med Wkly. 2008;138(9-10):128-33.

Wangdi K, Kasturiaratchi K, Nery SV, Lau CL, Gray DJ, Clements ACA. Diversity of infectious aetiologies of acute undifferentiated febrile illnesses in south and Southeast Asia: A systematic review. BMC Infect Dis. 2019;19(1):1-17.

Andrews MA, Ittyachen AM. Aetiology of acute febrile illness: a multicentre study from the province of Kerala in southern India. Trop Doct. 2018;48(4):322-5.

Sarriff A, Jummaat F, Khan AH, Mallhi TH, Khan YH, Adnan AS. Incidence, Characteristics and Risk Factors of Acute Kidney Injury among Dengue Patients: A Retrospective Analysis. PLoS One. 2015;10(9):e0138465.

Mbbs NM, Frcp GA. Short Report Acute kidney injury in dengue fever using Acute factors. 2012;12(July):160-2.

Lee IK, Liu JW, Yang KD. Clinical characteristics, risk factors, and outcomes in adults experiencing dengue hemorrhagic fever complicated with acute renal failure. Am J Trop Med Hyg. 2009;80(4):651-5.

Yang F, Zhang L, Wu H, Zou H, Du Y. Clinical analysis of cause, treatment and prognosis in acute kidney injury patients. PLoS One. 2014;9(2).

Czempik P, Cieśla D, Knapik P, Krzych Ł. Mortality of patients with acute kidney injury requiring renal replacement therapy. Adv Clin Exp Med. 2018;27(3):327-33

Lizarraga KJ, Nayer A. Dengue-associated kidney disease. J Nephropathol. 2014;3(2):57-62.

da Silva GB, De Francesco Daher E, Salani Mota RM, Menezes FA. Risk factors for death among critically ill patients with acute renal failure. Sao Paulo Med J. 2006;124(5):257-63.