Dialysis for acute kidney injury associated with influenza a (H1N1) infection

Abstract

In June 2009, the World Health Organization declared a novel influenza A, S-OIV (H1N1), pandemic. We observed 44 consecutive patients during the "first wave" of the pandemic. 70.5% of them showed co-morbidities (hypertension, obesity, chronic respiratory diseases, chronic renal disease, diabetes, pregnancy). Serious cases were admitted to the intensive care unit (ICU), particularly those with severe acute respiratory failure. Some of them developed acute kidney injury (AKI) and required renal replacement therapy (RRT). The average time between admission to the ICU and initiation of RRT was 3.16 ± 2.6 days. At initiation of RRT, most patients required mechanical ventilation. No relationship was found with creatinine-kinase levels. Seventy-five percent of the cases were observed during a 3-week period and mortality, related to respiratory failure, doubling of alanine amino transferase and use of inotropics was 81.8%. In conclusion, the H1N1-infected patients who developed RRT-requiring AKI, in the context of multi-organ failure, showed a high mortality rate. Thus, it is mandatory that elaborate strategies aimed at anticipating potential renal complications associated to future pandemics are implemented.

Acute Kidney Injury and Renal Replacement Therapy in COVID-19 Versus Other Respiratory Viruses: A Systematic Review and Meta-Analysis

“…The funnel plots ( Figure 4 ) revealed one outlying study on ACE2-associated viruses. 112 Removal of this study did not alter our conclusion for the comparisons between the 3 groups of viruses.…”

“…The full-texts of 901 articles were reviewed and 20 studies on ACE2-associated viruses and 3 studies on non-ACE2-associated viruses were included in the meta-analysis ( Figure 1B ). 95 - 117 The majority of the included COVID-19 studies were from the United States (n = 28) and China (n = 17) but other included studies were from England (n = 5), France (n = 4), Brazil (n = 3), South Korea (n = 2), Mexico (n = 2), and Canada, Sweden, Netherlands, Italy, Switzerland, Bahrain, India, United Arab Emirates, and Saudi Arabia (n = 1 each). The last study was conducted jointly in France and Spain.…”

“…Four studies reported extreme AKI rate of either 100% or less than 1% (2 COVID-19 studies and 2 studies which examined ACE2-associated viruses). 28,84,110,112 Sensitivity analysis which excluded these studies did not alter our conclusion for the comparisons between the 3 viruses.…”