Unique aspects of acute kidney injury associated with infections in the tropics: presentation, challenges, and opportunities

IF 21.8 1区医学 Q1 UROLOGY & NEPHROLOGY

Kidney international Pub Date : 2026-07-01 Epub Date: 2026-03-20 DOI:10.1016/j.kint.2026.02.025

Mythri Shankar , Sabine Karam , Sola Aoun Bahous , Bianca Davidson , Vivek Kumar , Sourabh Sharma , Kornchanok Vareesangthip , Mitchell H. Rosner , Eranga Wijewickrama

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Abstract

“The tropics” currently account for around 40% of the world’s population and face unique environmental challenges, with limited resources, a deficient health system, and a rudimentary sanitary infrastructure, in addition to a lack of adequate preventive measures and poor surveillance programs. Cases of acute kidney injury in the tropics are to a very large extent driven by infections such as leptospirosis, scrub typhus, dengue, malaria, Ebola virus, yellow fever, and HIV, with a pathogenesis driven by volume depletion, hypotension, and immune-mediated mechanisms. Many of these infections also lead to multiorgan failure and significant morbidity and mortality. Delayed diagnosis and limited access to kidney replacement therapy can further worsen the prognosis. Investment in preventive measures such as vector control, clean water access, robust vaccination programs, and health system strengthening is vital to reduce the incidence and severity of infection-associated acute kidney injury in the tropics.

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热带地区与感染相关的急性肾损伤的独特方面：呈现，挑战和机遇。

“热带地区”目前约占世界人口的40%，面临着独特的环境挑战，资源有限，卫生系统不足，卫生基础设施简陋，缺乏适当的预防措施和监测规划。热带地区的急性肾损伤（AKI）病例很大程度上是由钩端螺旋体病、恙虫病、登革热、疟疾、埃博拉病毒、黄热病和人类免疫缺陷病毒等感染引起的，其发病机制是由容量耗竭、低血压和免疫介导机制驱动的。许多这些感染还导致多器官衰竭和显著的发病率和死亡率。延迟诊断和有限的肾脏替代治疗可进一步恶化预后。投资于病媒控制、获得清洁水、强有力的疫苗接种规划和加强卫生系统等预防措施，对于降低热带地区感染相关急性呼吸道感染的发病率和严重程度至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Kidney international 医学-泌尿学与肾脏学

CiteScore

23.30

自引率

3.10%

发文量

490

审稿时长

3-6 weeks

期刊介绍： Kidney International (KI), the official journal of the International Society of Nephrology, is led by Dr. Pierre Ronco (Paris, France) and stands as one of nephrology's most cited and esteemed publications worldwide. KI provides exceptional benefits for both readers and authors, featuring highly cited original articles, focused reviews, cutting-edge imaging techniques, and lively discussions on controversial topics. The journal is dedicated to kidney research, serving researchers, clinical investigators, and practicing nephrologists.