Incidence, Risk Factors and Outcome of Renal Involvement in Patients of
Dengue Viral Infection Admitted to a Tertiary Care Hospital in
North-Western India: A single center, prospective observational study.
Abstract
Dengue Viral Infection (DVI) has emerged as one of tropical belts’ most
common mosquito-borne diseases worldwide. This study was an attempt to
evaluate the patterns of renal involvement in DVI and its effect on
morbidity and mortality arising from the illness. This study was
conducted on 170 patients hospitalized with the diagnosis of Dengue
fever in the Emergency department of the Post Graduate Institute of
Medical Education and Research, Chandigarh, from July 2022 to September
2023. All clinical and laboratory parameters of the patient were
recorded. To evaluate patterns of renal involvement, patients underwent
urine dipstick, urine routine and microscopy, spot urine
protein/creatinine ratio, creatinine and ultrasonography. Patients with
renal involvement were followed up for four weeks and 12 weeks. The
median age was 36 years, with 60% male patients. A total of 51 patients
(30%) had renal involvement, and 36 (21.17%) had Acute Kidney injury.
Ten patients developed KDIGO Stage 3 AKI, of which 7 required renal
replacement therapy. Forty-seven (27.6%) patients developed urinary
abnormalities (which included proteinuria, hematuria, and active
sediments in urine). Patients with renal involvement had significantly
higher mortality (p-value <0.001). Among the patients who
survived, renal abnormalities resolved in all except one, who progressed
to chronic kidney disease. Renal biopsy was done in three patients, and
cast nephropathy was seen in all. This study establishes that renal
involvement accompanies higher mortality in patients with DVI, thereby
underscoring the importance of its evaluation for the management and
prognostication of patients.