Acute kidney injury in severe dengue

Abstract

Background: Several forms of renal involvement have been identified in patients with dengue, including proteinuria, glomerulonephritis, and IgA nephropathy to acute kidney injury (AKI). Objective: The objective of the study was to know the type of AKI and the outcome of patients with AKI. Materials and Methods: All serologically proven dengue patients admitted in our wards/pediatric intensive care unit (PICU) were included in the study. A detailed history was done and a thorough clinical examination was performed on all the included patients. They were monitored for pulse pressure, urine output, hemoglobin, packed cell volume, and platelet counts regularly. On admission, renal function tests were done and assessed for pre-renal or renal AKI. Patients were managed as per the WHO protocol for dengue. Results: Based on the pediatric risk, injury, failure, loss, and end-stage renal disease criteria, we encountered an incidence of 61.3% of AKI, of which 45% were at risk of developing AKI and 15.9% had developed kidney injury. All the patients had pre-renal type of AKI. There were no deaths seen, but the length of stay was prolonged in patients with AKI. Conclusion: It is possible to detect renal involvement at an early phase, and by strict monitoring of fluid status, timely management can reduce the morbidity and mortality.