A clinical study of acute kidney injury in tropical acute febrile illness

Jayalal Jayapalan Nair, Ajay Bhat, Mangalore Venkatraya Prabhu

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Introduction: Tropical Acute Febrile Illness (TAFI) is one of the most common causes of morbidity within the community. Acute Kidney Injury (AKI) due to infective and non infective causes is a major complication. Presence of AKI is a major cause of mortality among patients with TAFI. Aim: To study the spectrum of tropical acute febrile illness; the proportion, spectrum and staging of acute kidney injury; Renal Replacement Therapy (RRT) initiation and in-hospital mortality. Materials and Methods: A total of 600 TAFI patients were prospectively studied at a tertiary care centre in coastal Karnataka between September 2012 and September 2014 for the aetiology of TAFI; the development and staging of AKI based on Kidney disease: Improving global outcomes (KDIGO) guidelines; the initiation of RRT and in-hospital mortality. Statistical Analysis: Data analysis was done using SPSS version 17. 0 with statistical significance calculated using chi-square and Fisher’s exact t-test for which p-value <0. 05 was considered significant. Results: The spectrum of TAFI, in decreasing order, was vivax malaria, leptospirosis, dengue fever, falciparum malaria, mixed malaria, enteric fever, scrub typhus and the most common aetiology was malaria. The proportion of AKI was 54%. The most common cause of AKI, its stages 2 and 3, RRT initiation and in-hospital mortality was leptospirosis; and AKI stage 1 was dengue fever. KDIGO AKI stage 1, 2 and 3 was seen in 46. 9%, 31. 2% and 21. 9% of AKI patients, respectively. RRT initiation was required in 10. 2% of AKI patients and in-hospital mortality was 3% among all patients. AKI, RRT initiationand in-hospital mortality were significantly associated with older age, fever duration and other presenting complaints, examination findings, renal function and other parameters, leptospirosis, dengue fever, falciparum malaria. Conclusion: The aetiology in about half of TAFI patients in coastal Karnataka was malaria. More than 50% develop AKI with greater than one-fifth of them progressing to AKI stage 3 and one-tenth requiring RRT. The most common cause of AKI, AKI stage 2, 3, RRT initiation and in-hospital mortality was leptospirosis. AKI was present in almost all patients with leptospirosis. Therefore leptospirosis is the most nephrotoxic acute febrile illness in the present study population. Dengue fever was the most common cause of AKI stage 1. Vivax malaria was the third most common cause of AKI. The factors like age, presenting complaints, examination findings, renal function and other parameters, aetiology and RRT initiation may be used to predict AKI and in-hospital mortality.

Original languageEnglish
Pages (from-to)OC01-OC05
JournalJournal of Clinical and Diagnostic Research
Volume10
Issue number8
DOIs
Publication statusPublished - 01-08-2016

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Acute Kidney Injury
Fever
Renal Replacement Therapy
Leptospirosis
Hospital Mortality
Dengue
Clinical Studies
Vivax Malaria
Malaria
Falciparum Malaria
Kidney Diseases
Scrub Typhus
Kidney
Typhoid Fever
Age Factors
Tertiary Care Centers

All Science Journal Classification (ASJC) codes

  • Clinical Biochemistry

Cite this

@article{4aa1972ffa9e4454af388c811824f04d,
title = "A clinical study of acute kidney injury in tropical acute febrile illness",
abstract = "Introduction: Tropical Acute Febrile Illness (TAFI) is one of the most common causes of morbidity within the community. Acute Kidney Injury (AKI) due to infective and non infective causes is a major complication. Presence of AKI is a major cause of mortality among patients with TAFI. Aim: To study the spectrum of tropical acute febrile illness; the proportion, spectrum and staging of acute kidney injury; Renal Replacement Therapy (RRT) initiation and in-hospital mortality. Materials and Methods: A total of 600 TAFI patients were prospectively studied at a tertiary care centre in coastal Karnataka between September 2012 and September 2014 for the aetiology of TAFI; the development and staging of AKI based on Kidney disease: Improving global outcomes (KDIGO) guidelines; the initiation of RRT and in-hospital mortality. Statistical Analysis: Data analysis was done using SPSS version 17. 0 with statistical significance calculated using chi-square and Fisher’s exact t-test for which p-value <0. 05 was considered significant. Results: The spectrum of TAFI, in decreasing order, was vivax malaria, leptospirosis, dengue fever, falciparum malaria, mixed malaria, enteric fever, scrub typhus and the most common aetiology was malaria. The proportion of AKI was 54{\%}. The most common cause of AKI, its stages 2 and 3, RRT initiation and in-hospital mortality was leptospirosis; and AKI stage 1 was dengue fever. KDIGO AKI stage 1, 2 and 3 was seen in 46. 9{\%}, 31. 2{\%} and 21. 9{\%} of AKI patients, respectively. RRT initiation was required in 10. 2{\%} of AKI patients and in-hospital mortality was 3{\%} among all patients. AKI, RRT initiationand in-hospital mortality were significantly associated with older age, fever duration and other presenting complaints, examination findings, renal function and other parameters, leptospirosis, dengue fever, falciparum malaria. Conclusion: The aetiology in about half of TAFI patients in coastal Karnataka was malaria. More than 50{\%} develop AKI with greater than one-fifth of them progressing to AKI stage 3 and one-tenth requiring RRT. The most common cause of AKI, AKI stage 2, 3, RRT initiation and in-hospital mortality was leptospirosis. AKI was present in almost all patients with leptospirosis. Therefore leptospirosis is the most nephrotoxic acute febrile illness in the present study population. Dengue fever was the most common cause of AKI stage 1. Vivax malaria was the third most common cause of AKI. The factors like age, presenting complaints, examination findings, renal function and other parameters, aetiology and RRT initiation may be used to predict AKI and in-hospital mortality.",
author = "Nair, {Jayalal Jayapalan} and Ajay Bhat and Prabhu, {Mangalore Venkatraya}",
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A clinical study of acute kidney injury in tropical acute febrile illness. / Nair, Jayalal Jayapalan; Bhat, Ajay; Prabhu, Mangalore Venkatraya.

In: Journal of Clinical and Diagnostic Research, Vol. 10, No. 8, 01.08.2016, p. OC01-OC05.

Research output: Contribution to journalArticle

TY - JOUR

T1 - A clinical study of acute kidney injury in tropical acute febrile illness

AU - Nair, Jayalal Jayapalan

AU - Bhat, Ajay

AU - Prabhu, Mangalore Venkatraya

PY - 2016/8/1

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N2 - Introduction: Tropical Acute Febrile Illness (TAFI) is one of the most common causes of morbidity within the community. Acute Kidney Injury (AKI) due to infective and non infective causes is a major complication. Presence of AKI is a major cause of mortality among patients with TAFI. Aim: To study the spectrum of tropical acute febrile illness; the proportion, spectrum and staging of acute kidney injury; Renal Replacement Therapy (RRT) initiation and in-hospital mortality. Materials and Methods: A total of 600 TAFI patients were prospectively studied at a tertiary care centre in coastal Karnataka between September 2012 and September 2014 for the aetiology of TAFI; the development and staging of AKI based on Kidney disease: Improving global outcomes (KDIGO) guidelines; the initiation of RRT and in-hospital mortality. Statistical Analysis: Data analysis was done using SPSS version 17. 0 with statistical significance calculated using chi-square and Fisher’s exact t-test for which p-value <0. 05 was considered significant. Results: The spectrum of TAFI, in decreasing order, was vivax malaria, leptospirosis, dengue fever, falciparum malaria, mixed malaria, enteric fever, scrub typhus and the most common aetiology was malaria. The proportion of AKI was 54%. The most common cause of AKI, its stages 2 and 3, RRT initiation and in-hospital mortality was leptospirosis; and AKI stage 1 was dengue fever. KDIGO AKI stage 1, 2 and 3 was seen in 46. 9%, 31. 2% and 21. 9% of AKI patients, respectively. RRT initiation was required in 10. 2% of AKI patients and in-hospital mortality was 3% among all patients. AKI, RRT initiationand in-hospital mortality were significantly associated with older age, fever duration and other presenting complaints, examination findings, renal function and other parameters, leptospirosis, dengue fever, falciparum malaria. Conclusion: The aetiology in about half of TAFI patients in coastal Karnataka was malaria. More than 50% develop AKI with greater than one-fifth of them progressing to AKI stage 3 and one-tenth requiring RRT. The most common cause of AKI, AKI stage 2, 3, RRT initiation and in-hospital mortality was leptospirosis. AKI was present in almost all patients with leptospirosis. Therefore leptospirosis is the most nephrotoxic acute febrile illness in the present study population. Dengue fever was the most common cause of AKI stage 1. Vivax malaria was the third most common cause of AKI. The factors like age, presenting complaints, examination findings, renal function and other parameters, aetiology and RRT initiation may be used to predict AKI and in-hospital mortality.

AB - Introduction: Tropical Acute Febrile Illness (TAFI) is one of the most common causes of morbidity within the community. Acute Kidney Injury (AKI) due to infective and non infective causes is a major complication. Presence of AKI is a major cause of mortality among patients with TAFI. Aim: To study the spectrum of tropical acute febrile illness; the proportion, spectrum and staging of acute kidney injury; Renal Replacement Therapy (RRT) initiation and in-hospital mortality. Materials and Methods: A total of 600 TAFI patients were prospectively studied at a tertiary care centre in coastal Karnataka between September 2012 and September 2014 for the aetiology of TAFI; the development and staging of AKI based on Kidney disease: Improving global outcomes (KDIGO) guidelines; the initiation of RRT and in-hospital mortality. Statistical Analysis: Data analysis was done using SPSS version 17. 0 with statistical significance calculated using chi-square and Fisher’s exact t-test for which p-value <0. 05 was considered significant. Results: The spectrum of TAFI, in decreasing order, was vivax malaria, leptospirosis, dengue fever, falciparum malaria, mixed malaria, enteric fever, scrub typhus and the most common aetiology was malaria. The proportion of AKI was 54%. The most common cause of AKI, its stages 2 and 3, RRT initiation and in-hospital mortality was leptospirosis; and AKI stage 1 was dengue fever. KDIGO AKI stage 1, 2 and 3 was seen in 46. 9%, 31. 2% and 21. 9% of AKI patients, respectively. RRT initiation was required in 10. 2% of AKI patients and in-hospital mortality was 3% among all patients. AKI, RRT initiationand in-hospital mortality were significantly associated with older age, fever duration and other presenting complaints, examination findings, renal function and other parameters, leptospirosis, dengue fever, falciparum malaria. Conclusion: The aetiology in about half of TAFI patients in coastal Karnataka was malaria. More than 50% develop AKI with greater than one-fifth of them progressing to AKI stage 3 and one-tenth requiring RRT. The most common cause of AKI, AKI stage 2, 3, RRT initiation and in-hospital mortality was leptospirosis. AKI was present in almost all patients with leptospirosis. Therefore leptospirosis is the most nephrotoxic acute febrile illness in the present study population. Dengue fever was the most common cause of AKI stage 1. Vivax malaria was the third most common cause of AKI. The factors like age, presenting complaints, examination findings, renal function and other parameters, aetiology and RRT initiation may be used to predict AKI and in-hospital mortality.

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