Prevalence, Characteristics, and Factors Associated with Acute Kidney Injury among Adult Dengue Patients in Vietnam

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  • 1 Department of Infectious Diseases, Hanoi Medical University, Hanoi, Vietnam;
  • 2 Pediatrics Department, National Hospital for Tropical Diseases, Hanoi, Vietnam

Acute kidney injury (AKI) is a serious and potentially lethal complication of dengue disease; however, the actual incidence in dengue patients in Vietnam is unknown. This study aimed to determine the prevalence, clinical and laboratory characteristics, and risk factors for AKI in adults with dengue. This is a multicenter, cross-sectional study conducted between January and December 2017 in 2,417 adult patients with dengue. Indicators of demographic, clinical, and laboratory findings were evaluated. The prevalence of dengue disease–associated AKI was 2.7% (64/2,417), and dengue patients with AKI had a higher mortality rate than patients without AKI (12.5% versus 0.6%; P < 0.01). Characteristics of AKI were more common in male gender (male: female was 6.1:1), a history of hypertension (7.8% versus 2.3%; P < 0.02), the situations of hemoconcentration (hematocrit > 44%; P < 0.008), hypovolemic shock (21.9% versus 6.8%; P < 0.01), organ failure (42.3% versus 2.3%; P < 0.01), or manifestations of myocarditis (20.3% versus 6.6%; P < 0.01), hyperbilirubinemia (28.7 ± 7.6 versus 12.0 ± 0.9; P < 0.01), elevated enzymes such as ALT (407 ± 151 versus 113 ± 6; P < 0.01) and AST (891 ± 475 versus 172 ± 11; P < 0.01), and prolonged PT (s) (13.9 ± 4.6 versus 12.3 ± 1.5; P < 0.01). Independent risk factors for AKI by multivariate analysis were male gender (OR: 43.6; 95% CI: 2.4–810), severe dengue classification (OR: 25.7; 95% CI: 2–333), and creatine kinase > 190 U/L (OR: 11.7; 95% CI: 1.1122.4). The study results indicate a need to continue studying the association between AKI and mortality in dengue disease and the need for improved management of AKI with dengue.

Author Notes

Address correspondence to Dang Thi Thuy, Pediatrics Department, National Hospital for Tropical Diseases, 78 Giai Phong St., Hanoi, Vietnam. E-mail: dangthuy.nhtd@gmail.com.

Authors’ addresses: Bui Vu Huy, Department of Infectious Diseases, Hanoi Medical University, Hanoi, Vietnam, E-mail: dr.vuhuy@yahoo.com. Dang Thi Thuy, Pediatrics Department, National Hospital for Tropical Diseases, Hanoi, Vietnam, E-mail: dangthuy.nhtd@gmail.com.

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