Acute kidney injury and tools for risk-stratification in 456 patients with hantavirus-induced nephropathia epidemica

Latus, Joerg; Schwab, Matthias; Tacconelli, Evelina; Pieper, F.; Wegener, Daniel; Rettenmaier, Bianka; Schwab, Albrecht; Hoffmann, Larissa; Dippon, Juergen; Müller, Simon; Fritz, Péter; Zakim, David; Segerer, Stephan; Kitterer, Daniel; Kimmel, Martin; Gußmann, Karl; Priwitzer, Martin; Mezger, Barbara; Walter-Frank, Birgit; Corea, A.; Wiedenmann, Albrecht; Brockmann, Stefan; Pöhlmann, Christoph; Alscher, Mark Dominik; Braun, Niko

doi:10.1093/ndt/gfu319

Cited by 41 publications

(50 citation statements)

References 38 publications

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“…In some German studies, severe thrombocytopenia has predicted severe AKI [48,49,50]. However, in these studies the research approach was different from our study and the number of patients was quite small, which may explain the divergent results.…”

Section: Discussioncontrasting

confidence: 59%

Community Acquired Severe Acute Kidney Injury Caused by Hantavirus-Induced Hemorrhagic Fever with Renal Syndrome Has a Favorable Outcome

Outinen¹,

Mäkelä²,

Clément³

et al. 2015

Nephron

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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.

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Section: Discussioncontrasting

confidence: 59%

Community Acquired Severe Acute Kidney Injury Caused by Hantavirus-Induced Hemorrhagic Fever with Renal Syndrome Has a Favorable Outcome

Outinen¹,

Mäkelä²,

Clément³

et al. 2015

Nephron

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“…Nephropathia epidemica (NE) was first described in Sweden in the 1930s and thousands of hantavirus infection cases occur annually throughout Europe (Latus et al, 2015b). Although a number of various hantavirus species [e.g., Dobrava-Belgrade virus (DOBV) and Tula hantavirus (TULV)] are circulating in Europe, Puumala virus (PUUV) is by far the most prevalent pathogen (Manigold and Vial, 2014;Kruger et al, 2013).…”

Section: Nephropathia Epidemica (Ne)mentioning

confidence: 99%

Hantavirus infection: a global zoonotic challenge

et al. 2017

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Hantaviruses are comprised of tri-segmented negative sense single-stranded RNA, and are members of the Bunyaviridae family. Hantaviruses are distributed worldwide and are important zoonotic pathogens that can have severe adverse effects in humans. They are naturally maintained in specific reservoir hosts without inducing symptomatic infection. In humans, however, hantaviruses often cause two acute febrile diseases, hemorrhagic fever with renal syndrome (HFRS) and hantavirus cardiopulmonary syndrome (HCPS). In this paper, we review the epidemiology and epizootiology of hantavirus infections worldwide.

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“…En aquellos casos ajustados a la definición se sugiere realizar estudio con técnicas rápidas que detecten IgM anti-hantavirus 17,18 . Según datos preliminares del laboratorio (no publicados aún) el ensayo inmunocromatográfico IgM POC Puumala mostró sensibilidad y especificidad de 97% 10,17 .…”

Section: Artículo Originalunclassified

Correlación entre criterios clínicos y de laboratorio de casos notificados por sospecha de hantavirosis y el resultado de la técnica de referencia

Hott

Caroca

Leyton

et al. 2016

Rev. chil. infectol.

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10%), presenta: S: 25%, E: 98%, VPP: 37%, VPN: 97%. Paratrombocitopenia se obtuvo: S: 98%, E: 74%, VPP: 16%, VPN: 100%. Conclusión: Se hace necesario reiterar a nivel del sistema sanitario chileno la importancia de contar con datos completos en los formularios de notificación. La presencia de trombocitopenia e inmunoblastos (> 10%) fue altamente sensible y especifica, respectivamente, en la detección de pacientes con SCPH. Con el fin de optimizar la sospecha de infección por hantavirus, según la definición de caso sospechoso, se plantea la necesidad de desarrollar programas de capacitación para la sospecha clínica y lectura de parámetros de laboratorio, tales como presencia de inmunoblastos en el hemograma, así como incluir un algoritmo con el fin de optimizar la sospecha y el uso adecuado de los recursos sanitarios.]]>

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Acute kidney injury and tools for risk-stratification in 456 patients with hantavirus-induced nephropathia epidemica

Abstract: This clinical prediction rule provides a novel and diagnostically accurate strategy for the potential prevention and improved management of kidney complications in patients with NE and, ultimately, for a possible decrease in unnecessary hospitalization in a high number of patients.

Cited by 41 publications

References 38 publications

Community Acquired Severe Acute Kidney Injury Caused by Hantavirus-Induced Hemorrhagic Fever with Renal Syndrome Has a Favorable Outcome

Community Acquired Severe Acute Kidney Injury Caused by Hantavirus-Induced Hemorrhagic Fever with Renal Syndrome Has a Favorable Outcome

Hantavirus infection: a global zoonotic challenge

Correlación entre criterios clínicos y de laboratorio de casos notificados por sospecha de hantavirosis y el resultado de la técnica de referencia

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