RESEARCH ARTICLE
Incidence, Characteristics and Risk Factors of Acute Kidney Injury among Dengue Patients: A Retrospective Analysis Tauqeer Hussain Mallhi1,2*, Amer Hayat Khan1,2, Azreen Syazril Adnan2, Azmi Sarriff1, Yusra Habib Khan1,2, Fauziah Jummaat3 1 Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, University Sains Malaysia, Penang, Malaysia, 2 Chronic Kidney Disease Resource Centre, School of Medical Sciences, Health Campus, University Sains Malaysia, Kubang Kerain, Kelantan, Malaysia, 3 Department of Obstetrics and Gynecology, School of Medical Sciences, Health Campus, University Sains Malaysia, Kubang Kerain, Kelantan, Malaysia * [email protected]
Abstract Background OPEN ACCESS Citation: Mallhi TH, Khan AH, Adnan AS, Sarriff A, Khan YH, Jummaat F (2015) Incidence, Characteristics and Risk Factors of Acute Kidney Injury among Dengue Patients: A Retrospective Analysis. PLoS ONE 10(9): e0138465. doi:10.1371/ journal.pone.0138465 Editor: Zaccaria Ricci, Bambino Gesù Children's Hospital, ITALY Received: June 3, 2015
Dengue induced acute kidney injury (AKI) imposes heavy burden of illness in terms of morbidity and mortality. A retrospective study was conducted to investigate incidence, characteristics, risk factors and clinical outcomes of AKI among dengue patients.
Methodology A total 667 dengue patients (2008–2013) were retrospectively evaluated and were stratified into AKI and non-AKI groups by using AKIN criteria. Two groups were compared by using appropriate statistical methods.
Accepted: August 31, 2015 Published: September 30, 2015 Copyright: © 2015 Mallhi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability Statement: All relevant data are within the paper. Funding: The authors are thankful to Institute of Postgraduate Studies (IPS) of University Sains Malaysia (USM) for fellowship support [Ref. no. PFD0010/149(R). Competing Interests: The authors have declared that no competing interests exist.
Results There were 95 patients (14.2%) who had AKI, with AKIN-I, AKIN-II and AKIN-III in 76.8%, 16.8% and 6.4% patients, respectively. Significant differences (P10 × upper limit normal) and mortality. In order to discharge outcomes reference values for AST and ALT were 5–34 IU/L and 10–35 IU/L.
Definitions For the purpose of current study, terms used were defined as follow: Hospital stay is defined by >1 day bed occupancy in hospital; mortality means death within 14 days after admission; hypokalemia (K < 3.5 mmol/L); hyponatremia (Na < 135 mmol/L); oliguria (UO < 400 ml/day after 24 hours of appropriate hydration); hypotension (blood pressure < 110/70 mmHg); elevated transaminases (elevation of liver enzymes such as aspartate aminotransferase [AST] and/or alanine aminotransferase [ALT] >2 times the normal value); transaminitis (elevation of both ALT and AST), prolonged prothrombin time (PT > 15 seconds); prolonged activated partial thromboplastin time (aPTT > 35 seconds); urinary sedimentations (presence of glycosuria, hematuria, proteinuria, leucocytouria, urine pus, urine epithelial cells); anemia (Hb < 12 g/dL); dengue viral infection (dengue fever, dengue hemorrhagic fever, dengue shock syndrome); severe dengue (DHF, DSS); mild AKI (AKIN-I); severe AKI (AKIN-II, AKIN-III); transaminitis (elevation of both ALT and AST); multiple organ dysfunction (dysfunction of 2 organs, including AKI); hepatic dysfunction (elevation of liver enzymes); and thrombocytopenia (platelets count < 100×109 cells). Reference values for different laboratory parameters in current study are according to hospital laboratory i.e. calcium (2.2–2.5 mmol/L); serum phosphorous (0.9–1.3 mmol/L); serum chloride (95–105 mmol/L); BUN (1.7–8.3 mmol/L); uric acid (210–420 μmol/L); albumin (38–44 g/L); AST (5– 34 IU/L); ALT (10–35 IU/L); ALP (♂: 53–168 ♀: 42–98 IU/L); total bilirubin (
Incidence, Characteristics and Risk Factors of Acute Kidney Injury among Dengue Patients: A Retrospective Analysis Tauqeer Hussain Mallhi1,2*, Amer Hayat Khan1,2, Azreen Syazril Adnan2, Azmi Sarriff1, Yusra Habib Khan1,2, Fauziah Jummaat3 1 Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, University Sains Malaysia, Penang, Malaysia, 2 Chronic Kidney Disease Resource Centre, School of Medical Sciences, Health Campus, University Sains Malaysia, Kubang Kerain, Kelantan, Malaysia, 3 Department of Obstetrics and Gynecology, School of Medical Sciences, Health Campus, University Sains Malaysia, Kubang Kerain, Kelantan, Malaysia * [email protected]
Abstract Background OPEN ACCESS Citation: Mallhi TH, Khan AH, Adnan AS, Sarriff A, Khan YH, Jummaat F (2015) Incidence, Characteristics and Risk Factors of Acute Kidney Injury among Dengue Patients: A Retrospective Analysis. PLoS ONE 10(9): e0138465. doi:10.1371/ journal.pone.0138465 Editor: Zaccaria Ricci, Bambino Gesù Children's Hospital, ITALY Received: June 3, 2015
Dengue induced acute kidney injury (AKI) imposes heavy burden of illness in terms of morbidity and mortality. A retrospective study was conducted to investigate incidence, characteristics, risk factors and clinical outcomes of AKI among dengue patients.
Methodology A total 667 dengue patients (2008–2013) were retrospectively evaluated and were stratified into AKI and non-AKI groups by using AKIN criteria. Two groups were compared by using appropriate statistical methods.
Accepted: August 31, 2015 Published: September 30, 2015 Copyright: © 2015 Mallhi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability Statement: All relevant data are within the paper. Funding: The authors are thankful to Institute of Postgraduate Studies (IPS) of University Sains Malaysia (USM) for fellowship support [Ref. no. PFD0010/149(R). Competing Interests: The authors have declared that no competing interests exist.
Results There were 95 patients (14.2%) who had AKI, with AKIN-I, AKIN-II and AKIN-III in 76.8%, 16.8% and 6.4% patients, respectively. Significant differences (P10 × upper limit normal) and mortality. In order to discharge outcomes reference values for AST and ALT were 5–34 IU/L and 10–35 IU/L.
Definitions For the purpose of current study, terms used were defined as follow: Hospital stay is defined by >1 day bed occupancy in hospital; mortality means death within 14 days after admission; hypokalemia (K < 3.5 mmol/L); hyponatremia (Na < 135 mmol/L); oliguria (UO < 400 ml/day after 24 hours of appropriate hydration); hypotension (blood pressure < 110/70 mmHg); elevated transaminases (elevation of liver enzymes such as aspartate aminotransferase [AST] and/or alanine aminotransferase [ALT] >2 times the normal value); transaminitis (elevation of both ALT and AST), prolonged prothrombin time (PT > 15 seconds); prolonged activated partial thromboplastin time (aPTT > 35 seconds); urinary sedimentations (presence of glycosuria, hematuria, proteinuria, leucocytouria, urine pus, urine epithelial cells); anemia (Hb < 12 g/dL); dengue viral infection (dengue fever, dengue hemorrhagic fever, dengue shock syndrome); severe dengue (DHF, DSS); mild AKI (AKIN-I); severe AKI (AKIN-II, AKIN-III); transaminitis (elevation of both ALT and AST); multiple organ dysfunction (dysfunction of 2 organs, including AKI); hepatic dysfunction (elevation of liver enzymes); and thrombocytopenia (platelets count < 100×109 cells). Reference values for different laboratory parameters in current study are according to hospital laboratory i.e. calcium (2.2–2.5 mmol/L); serum phosphorous (0.9–1.3 mmol/L); serum chloride (95–105 mmol/L); BUN (1.7–8.3 mmol/L); uric acid (210–420 μmol/L); albumin (38–44 g/L); AST (5– 34 IU/L); ALT (10–35 IU/L); ALP (♂: 53–168 ♀: 42–98 IU/L); total bilirubin (
