Characteristics and outcomes of adults hospitalized with Dengue viral infection and acute Kidney injury in southern Thailand

Abstract

Dengue viral infection (DVI) among adult patients is increasingly problematic in tropical and subtropical regions. Acute kidney injury (AKI) after DVI poses substantial clinical outcomes and economic impact. This prospective study focused on the characteristics, risk factors, and outcomes of adult patients with AKI due to DVI hospitalized in nine network hospitals within Southern Thailand from January 2017 to December 2019. Among 120 adult patients hospitalized due to DVI without preexisting kidney diseases, 17 patients (14%) presented with AKI. During hospitalization, four patients required acute hemodialysis. The predominant characteristic of urinalysis was proteinuria, followed by pyuria and hematuria with remarkable dysmorphic red blood cells. Complications included acidosis, followed by hyperkalemia and volume overload. Most complications and deterioration of renal function occurred within the first week, but renal function recovered in second week of hospitalization. Stability of renal function was regained within the fourth week to the third month. However, four AKI patients recovered, with estimated glomerular filtration rate .60 mL/min/1.73 m2 within 3 months. Forty-day mortality rate and resource utilization, including hospital cost and length of hospitalization, among those with AKI were significantly higher than those without AKI. Thirty-day and in-hospital mortality rate among those with AKI was also higher than those without AKI. High APACHE II scores due to bleeding disorder and current use of non-steroidal anti-inflammatory agent were significantly associated with the emergence of AKI. Acute kidney injury among adult patients hospitalized due to DVI should be a concern and should be monitored for prompt treatment and follow-up.