Dengue Infection Causing Acute Kidney Injury

Abstract

Objective: We aim to report patients coming to this tertiary care center, developing acute kidney injury (AKI) after Dengue infection. Methods: An observational study of patients identified as having AKI after Dengue infection. AKI was defined according to RIFLE criteria with sudden rise in creatinine or decline in urine output or both. All patients had normal size non obstructed kidneys on ultrasonography, with no previous co morbid. Dengue was diagnosed on detection of dengue-specific IgM capture antibody or a four-fold or greater increase of dengue-specific IgG capture antibody by ELISA. Results: From January 2000 – December 2014, total 3525 patients with AKI registered at this institution, of these 43 (1.21%) developed AKI in association with dengue infection. Average age of patients was 34.65 ± 14.50 (range 16-90 years) with 31 male and 12 female. Jaundice and oligo-anuria were most common associated symptoms with fever. Renal replacement therapy required in 31 (72.09%) patients. Complete recovery was seen in 37 (86%), while 6 (14%) died during acute phase of illness. Age, jaundice, thrombocytopenia and shock were the factors significantly associated with high mortality. Conclusion: AKI though less reported, remains dreaded complication of dengue virus infection. With involvement of liver, circulatory system and prolonged thrombocytopenia mortality is high.