Renal Involvement in Children with Dengue Fever: A Study in Tertiary Care Hospital of Bangladesh

Prevalence of acute kidney injury among dengue cases: a systematic review and meta-analysis

Numerous studies have shown a correlation between dengue virus (DENV) infection and kidney disease. However, there is no existing meta-analysis on the prevalence of kidney diseases in the dengue population. A thorough systematic review and meta-analysis were undertaken to determine the prevalence of renal problems in people with DENV infection in order to fill this knowledge gap. A rigorous electronic literature search was carried out up to 25 January 2023 in a number of databases, including ProQuest, EBSCOhost, Scopus, PubMed and Web of Science. The search aimed to find articles that reported on the prevalence of kidney diseases in patients with DENV infection. Using the modified Newcastle-Ottawa Scale, the quality of the included studies was assessed. The meta-analysis included a total of 37 studies with 21 764 participants reporting on the prevalence of acute kidney injury (AKI) in individuals with DENV infection. The pooled prevalence of AKI in dengue patients was found to be 8% (95% confidence interval 6 to 11), with high heterogeneity across studies. The studies included are of moderate quality. The study revealed a high AKI prevalence in dengue patients, underlining the need for regular renal examination to detect AKI early and reduce hospitalization risk. Further research is needed to understand the dengue-kidney relationship and develop effective management strategies.

Acute Liver Failure in Dengue: A Common but Overlooked Entity in Pediatric Patients in Tropical Countries

OBJECTIVE

The objective of the study is to estimate the incidence of acute liver failure (ALF) in dengue infection, understand the demographic and biochemical profiles, and identify prognostic factors associated with mortality.

METHODOLOGY

This is a retrospective observational study. We evaluated the data of all pediatric dengue patients admitted over the last 5 years in our hospital to identify patients who fulfilled the criteria for pediatric ALF. Demographic profile, and biochemical and radiological parameters were assessed. Their outcomes and mortality data were analyzed to identify prognostic factors.

RESULTS

Thirty children with dengue infection were identified to have developed a during the ALF study period which was 29.1% (30 of 103) of all our ALF admissions. A total of 189 children with dengue infection needed admission during the same period and 15.8% (30 of 189) of them developed ALF. The mean duration of onset of ALF was 5.4 days after fever onset. Twenty-two patients (73%) survived, and 8 patients expired. High creatinine, low albumin level, and multisystemic involvement were identified as poor prognostic markers in those patients who did not survive.

CONCLUSION

ALF is common in admitted severe dengue patients. A significant proportion of acute liver patients in endemic countries can be attributed to dengue infection. Low serum albumin, high creatinine, and multi-organ dysfunction during acute illness can be used as prognostic markers in these children. Multicentric prospective studies are needed to validate these results.

Renal Manifestations in Children with Dengue Fever Hospitalized in Pediatric Intensive Care Unit

OBJECTIVE

To study the pattern of acute kidney injury in children with dengue infection hospitalized in an intensive care unit.

METHODS

This is a retrospective study from January 2019 through December 2019. Various renal manifestations of dengue were studied and compared between the severity of dengue fever.

RESULTS

Three hundred nineteen children with dengue fever were hospitalized and 127 needed intensive care admission. Among the 127 patients, 26 (20.5%) children developed acute kidney injury (AKI). Children with severe dengue developed a higher number of AKI (n = 20; 28.6%), as compared to dengue with warning sign group (n = 6; 11.8%). Colloid infusion, inotropic support, ventilatory requirement and presence of secondary hemophagocytic lymphohistiocytosis were the risk factors for AKI. Nine children underwent dialysis. Among the AKI group, 23 recovered and 3 died and all three had multi organ dysfunction syndrome.

CONCLUSIONS

It is essential to recognize the various renal manifestations of dengue AKI which is associated with increased mortality and morbidity.