Acute kidney injury due to tropical infectious diseases and animal venoms: a tale of 2 continents

Burdmann, Emmanuel A.; Jha, Vivekanand

doi:10.1016/j.kint.2016.09.051

Cited by 47 publications

(39 citation statements)

References 234 publications

(291 reference statements)

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“…Lack of universal health coverage and insufficient funding for the health system imposes significant cost of treatment for the patients and family, including high cost procedures such as ICU and renal replacement therapy [38]. Tropical infectious diseases, animal venoms, natural medicine, abortion and eclampsia are known to be important AKI etiological factors in developing countries [39,40]; however, their incidence was extremely low in the ICU population. This is likely due to the limited number of ICUs, which are located mostly in larger urban cities, as well as inadequate recognition of high-risk AKI patients in the primary health system.…”

Section: Discussionmentioning

confidence: 99%

A systematic review and meta-analysis of acute kidney injury in the intensive care units of developed and developing countries

et al. 2020

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Objectives Although the majority of the global population lives in developing countries, most of the epidemiological data related to intensive care unit (ICU) acute kidney injury (AKI) comes from developed countries. This systematic review aims to ascertain the methodology of studies on ICU AKI patients in developing and developed countries, to determine whether epidemiological comparisons between these two settings are possible, and to present a summary estimate of AKI incidence. Methods A systematic review of published studies reporting AKI in intensive care units (2005-2015) identified in PubMed, LILACS, and IBECs databases was conducted. We compared developed and developing countries by evaluating study methodology, AKI reference serum creatinine definitions, population characteristics, AKI incidence and mortality. AKI incidence was calculated with a random-effects model. Results Ninety-two studies were included, one of which reported data from both country categories: 60 from developed countries (1,057,332 patients) and 33 from developing countries (34,539 patients). In 78% of the studies, AKI was defined by the RIFLE, AKIN or KDIGO criteria. Oliguria had 11 different definitions and reference creatinine 23 different values. For the metaanalysis, 38 studies from developed and 18 from developing countries were selected, with similar AKI incidence: 39.3% and 35.1%, respectively. The need for dialysis, length of ICU stay and mortality were higher in developing countries.

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Section: Discussionmentioning

confidence: 99%

A systematic review and meta-analysis of acute kidney injury in the intensive care units of developed and developing countries

et al. 2020

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“…[9][10][11][12] Chikungunya viral infections have few but life threating acute complications like encephalitis 13 and cardiomyopathy 14 , but nephritis 4 is rarely reported. Infection associated glomerulonephritis and AKI is common in tropics [15][16][17] , but as an aetiology, chikungunya 3,18 is occasionally mentioned. We assume, as a cause of AKI, chikungunya is a potential candidate because patients may have GI symptoms causing volume depletion and pre-renal AKI, they are prone to develop NSAIDs induced AKI as many patients are likely to require pain killers 2 in acute chikungunya arthritis.…”

Section: Resultsmentioning

confidence: 99%

Risk factors for acute kidney injury among patients with chikungunya: a multi-center experience from the 2017 chikungunya outbreak in Dhaka, Bangladesh

et al. 2019

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Background: Chikungunya is an emerging viral infection in Bangladesh. This self-limiting febrile illness may have acute life-threating features including cardiomyopathy and encephalitis. Acute kidney injury (AKI) is less well described complication of chikungunya. This study was designed to evaluate risk factors for AKI among patients with chikungunya virus infection. Methods: This case-control study was done in 3 different centers in Dhaka, Bangladesh from July to October 2017. Adult patients (>18 years) with confirmed diagnosis of chikungunya were included in this study. AKI was diagnosed as per Kidney Disease: Improving Global Outcomes (KDIGO) Clinical Practice Guideline for Acute Kidney Injury. Patients suffering from chikungunya complicated by AKI were cases and those without AKI were controls. Results: Total patients were 107 (male 61) with a mean age of 35.6 (range 19-84) years. Common comorbidities were diabetes mellitus (DM) (20.6%), hypertension (17.8%) and chronic kidney disease (CKD) (12.1%). Common presentations included fever (86.9%) or recent history of fever (13.1%), joint pain (88.8%), rash (23.4%), pruritus (15.9%), gastro-intestinal (GI) features like diarrhea and/or vomiting (28%), lymphadenopathy (12.1%), gum swelling/oral ulcer (4.1%) and oedema (8.4%). Fourteen (13.1%) patients required hospitalization. Eleven (10.3%) cases were complicated by AKI. Among the risk factors for AKI, comorbidities like DM (OR 28.73, 95% CI 5.57-148.10, p 0.0001) and CKD (OR 31.0, 95% CI 2.94-326.7, p <0.0001), GI features (OR 16.07, 95% CI 3.22-80.14, p 0.0007), requirement of hospitalization (OR 23.10, 95% CI 2.37-226.31, p <0.0001) and use of angiotensin converting enzyme inhibitors/angiotensin receptor blockers (ACEIs/ARBs) (OR 6.65, 95% CI 1.77-24.98, p 0.005) were significant. Conclusions: One-tenth of adult patients suffering from chikungunya were complicated by AKI in this study. DM, CKD, diarrhea and/or vomiting, hospitalization and use of ACEIs/ARBs appeared as significant risk factors for AKI. Birdem Med J 2019; 9(3): 193-196

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“…In 4 of 15 clinically-presumed cases, rickettsioses were confirmed, suggesting that these features are not exclusive to leptospirosis. Other diseases that may present with jaundice or acute kidney injury include cholecystitis, hepatitis, arbovirus infection, malaria, hantavirus infection, and rickettsioses [29,30]. As such, laboratory testing is needed to help distinguish the etiology.…”

Section: Discussionmentioning

confidence: 99%

Leptospirosis in Indonesia: diagnostic challenges associated with atypical clinical manifestations and limited laboratory capacity

et al. 2020

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Background: The burden of leptospirosis in Indonesia is poorly understood. Data from an observational study conducted from 2013 to 2016 in seven cities across Indonesia was used to estimate the incidence of leptospirosis and document its clinical manifestations in patients requiring hospitalization. Methods: Specimens from patients hospitalized with acute fever were collected at enrollment, 14-28 days, and 3 months. Demographic and clinical information were collected during study visits and/or retrieved from medical records and double-entered into clinical report forms. After initially screening for dengue virus and other pathogens, specimens were tested at a central Reference Laboratory for anti-Leptospira IgM using commercial ELISA kits and for Leptospira DNA using an in-house quantitative real-time PCR assay. Results: Of 1464 patients enrolled, 45 (3.1%) confirmed cases (by PCR and/or sero-coversion or four-fold increase of IgM) and 6 (0.4%) probable cases (by high titer IgM) of leptospirosis were identified by the Reference Laboratory. Disease incidence at sites ranged from 0 (0%) cases in Denpasar to 17 (8.9%) cases in Semarang. The median age of patients was 41.2 years (range of 5.3 to 85.0 years), and 67% of patients were male. Twenty-two patients (43.1%) were accurately diagnosed at sites, and 29 patients (56.9%) were clinically misdiagnosed as having another infection, most commonly dengue fever (11, 37.9%). Clinically, 20 patients (39.2%) did not present with hyperbilirubinemia or increased creatinine levels. Two patients (3.9%) died, both from respiratory failure. Fifteen patients (29.4%) clinically diagnosed with leptospirosis at sites were negative based on IgM ELISA and/or PCR at the Reference Laboratory. Conclusions: Leptospirosis remains an important cause of hospitalization in Indonesia. It can have diverse clinical presentations, making it difficult to differentiate from other common tropical infections. PCR combined with ELISA is a powerful alternative to the cumbersome gold-standard microscopic agglutination test, particularly in resourcelimited settings.

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Acute kidney injury due to tropical infectious diseases and animal venoms: a tale of 2 continents

Cited by 47 publications

References 234 publications

A systematic review and meta-analysis of acute kidney injury in the intensive care units of developed and developing countries

A systematic review and meta-analysis of acute kidney injury in the intensive care units of developed and developing countries

Risk factors for acute kidney injury among patients with chikungunya: a multi-center experience from the 2017 chikungunya outbreak in Dhaka, Bangladesh

Leptospirosis in Indonesia: diagnostic challenges associated with atypical clinical manifestations and limited laboratory capacity

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