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Am. J. Trop. Med. Hyg., 80(2), 2009, pp. 279-285
Copyright © 2009 by The American Society of Tropical Medicine and Hygiene

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Potential Renal Sequelae in Survivors of Hantavirus Cardiopulmonary Syndrome

Steven A. Pergam, Darren W. Schmidt, Robert A. Nofchissey, William C. Hunt, Antonia H. Harford, AND Diane E. Goade*
Department of Medicine, University of Washington, Seattle, Washington; Department of Medicine, University of Mississippi, Jackson, Mississippi; Department of Medicine, University of New Mexico, Albuquerque, New Mexico; Cancer Research and Treatment Center, University of New Mexico, Albuquerque, New Mexico

Although other hantaviruses are associated with renal manifestations, hantavirus cardiopulmonary syndrome (HCPS) has not been associated with such sequelae. The HCPS survivors were prospectively evaluated for renal complications. Subjects underwent yearly evaluation, laboratory studies, and 24-hour urine collection. Thirty subjects were evaluated after recovery from HCPS with the first follow-up at a median of 7.4 months after discharge. Subjects were a wide age range (18–51) but had an equal gender composition. Eighteen of 30 (60%) returned for > 1 evaluation. Half (15/30) had a 24-hour urine collection with > 150 mg of total protein and 6 had > 300 mg. Seven had a Cockcroft-Gault creatinine clearance (CrClCG) < 90 mL/min/1.73 m2 and 2 were < 60. Fifty-three percent met the definition of chronic kidney disease. Those treated with extracorporeal membrane oxygenation had less renal sequelae (P = 0.035). Our data suggest that renal sequelae may occur in HCPS. Further study of renal complications of New World hantavirus infections are needed.

Received March 5, 2008. Accepted for publication September 28, 2008.

Acknowledgments: We acknowledge the significant contributions of the following individuals and groups: Cindy Wootton, the nurses and support staff of the University of New Mexico GCRC, the New Mexico State Department of Health, and the members of the Hantavirus Long-term Survivors Study Group.

Financial support: This study was supported by DHHS/NIH/NCRR/ GCRC Grant #5M01RR00997 (DG) and the Dedicated Research Funds of the University of New Mexico Health Science Center. Dr. Pergam is supported by NIAID Grant # T32 AI007044 and the Joel Meyers Foundation.

* Address correspondence to Diane E. Goade, MSC 10-5550, 1 University of New Mexico, Albuquerque, NM 87131. E-mail: dgoade{at}salud.unm.edu

Authors’ addresses: Steven A. Pergam, Fred Hutchinson Cancer Center, 1100 Fairview Avenue North, D3-100, P.O. Box 19024, Seattle, WA 98109, Tel: 206-667-7538, Fax: 206-667-4411, E-mail: spergam{at}fhcrc.org. Darren W. Schmidt, University of Mississippi, Division of Nephrology, 2500 North State Street, Jackson, MS 39216, Tel: 601-984-5670, Fax: 612-984-5765. Robert A. Nofchissey and Diane E. Goade, MSC 10-5550, 1 University of New Mexico, Albuquerque, NM 87131, Tel: 505-272-4903, Fax: 505-272-4403, E-mail: dgoade{at}salud.unm.edu. William C. Hunt, University of New Mexico Cancer Center, MSC08 4630, 1 University of New Mexico, Albuquerque, NM 87131, Tel: 505-272-4946, Fax: 505-272-1465. Antonia H. Harford, University of New Mexico, Division of Nephrology, MSC 10-5550, 1 University of New Mexico, Albuquerque, NM 87131, Tel: 505-272-4750, Fax: 505-272-2349.

Reprint requests: Diane E. Goade, MSC 10-5550, 1 University of New Mexico, Albuquerque, NM 87131, E-mail: dgoade{at}salud.unm.edu.






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