Community Acquired Severe Acute Kidney Injury Caused by Hantavirus-Induced Hemorrhagic Fever with Renal Syndrome Has a Favorable Outcome
| Autor: | Jan Clement, Tuula K. Outinen, Ilkka Pörsti, Jukka Mustonen, Antti Paakkala, Satu Mäkelä |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Renal function macromolecular substances Kidney Function Tests urologic and male genital diseases Puumala virus Gastroenterology Cohort Studies Young Adult Renal Dialysis Internal medicine medicine Humans Favorable outcome Puumala hantavirus Intensive care medicine Acute tubulointerstitial nephritis Finland Aged Hantavirus biology urogenital system business.industry Acute kidney injury virus diseases Acute Kidney Injury Middle Aged Prognosis biology.organism_classification medicine.disease female genital diseases and pregnancy complications Blood Cell Count Creatinine Hemorrhagic Fever with Renal Syndrome Female Radiography Thoracic Creatinine blood business Glomerular Filtration Rate |
| Zdroj: | Nephron. 130:182-190 |
| ISSN: | 2235-3186 1660-8151 |
| DOI: | 10.1159/000433563 |
| Popis: | Background: Puumala hantavirus (PUUV) induces an acute tubulointerstitial nephritis and acute kidney injury (AKI). Our aim was to evaluate the prognosis of severe AKI associated with PUUV infection. Methods: We examined 556 patients who were treated at Tampere University Hospital during 1982-2013 for acute, serologically confirmed PUUV infection. Plasma creatinine was measured during hospitalization, convalescence, and 1, 2, and 5 years after the acute infection. Results: Plasma creatinine concentration was elevated (>100 μmol/l) in 459 (83%) patients, while altogether 189 patients (34%) had severe AKI defined as Kidney Disease: Improving Global Outcomes (KDIGO) stage 3, that is, plasma creatinine ≥353.6 μmol/l (4.0 mg/dl) or need of dialysis. There were no fatal cases during the hospitalization or the following 3 months. Fatality rate during the years following PUUV infection did not differ between patients who had suffered from severe AKI versus those without severe AKI. Post-hospitalization plasma creatinine values were available for 188 (34%) patients. One month after the acute infection, patients with prior severe AKI had higher median plasma creatinine concentration (82 µmol/l, range 54-184) than patients without severe AKI (74 µmol/l, range 55-109, p = 0.005). After 1 year, no significant difference existed in median plasma creatinine concentrations between patients with (71 µmol/l, range 36-123) and without prior severe AKI (72 µmol/l, range 34-116, p = 0.711). After 5 years all but 1 patient had normal creatinine levels. Conclusions: In contrast to the worldwide well-accepted KDIGO criteria, severe AKI associated with PUUV infection is not associated with excess fatality but has a very good prognosis, both in the short and long terms. |
| Databáze: | OpenAIRE |
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