Basu Biswanath, Roy Birendranath
Division of Pediatric Nephrology, Department of Pediatrics, NRS Medical College and Hospital, Kolkata, West Bengal, India.
Department of Pediatrics, NRS Medical College and Hospital, Kolkata, West Bengal, India.
Indian J Crit Care Med. 2018 Jan;22(1):30-33. doi: 10.4103/ijccm.IJCCM_94_17.
Dengue is currently one of the most important mosquito-borne viral infections. Acute renal failure (ARF) is a serious complication among children suffering from dengue infection.
A retrospective cohort review of baseline characteristics, disease outcomes, and risk factors of dengue-infected patients, with and without renal failure (RF), were compared.
Among 97 children with dengue, 13.4% had RF (estimated glomerular filtration rate <60 ml/min/1.73 m) at presentation. In comparison to all children (100%) of RF cohort, only 32% children of non-RF cohort ( < 0.0001) were suffering either from dengue hemorrhagic fever (DHF) or dengue shock syndrome (DSS). The 7-day survival rate was 61.5% (8/13) among RF group as compared to 96.4% (81/84) in non-RF group ( < 0.001). When a fraction of patients who needed vasopressor support were significantly higher in RF cohort (70% vs. 14% for RF and non-RF, respectively, < 0.001), requirement of mechanical ventilation (15% vs. 11%, = 0.67) was comparable in both cohorts.
DHF/DSS is an independent risk factor for the development of ARF in patients with dengue infection. Mortality rate is high once RF develops in these children.
登革热是目前最重要的蚊媒病毒感染之一。急性肾衰竭（ARF）是登革热感染患儿的严重并发症。
对登革热感染患者的基线特征、疾病转归及危险因素进行回顾性队列研究，比较有和无肾衰竭（RF）患者的情况。
97例登革热患儿中，13.4%在就诊时出现RF（估计肾小球滤过率<60 ml/min/1.73 m²）。与RF队列的所有患儿（100%）相比，非RF队列中仅有32%的患儿（<0.0001）患有登革出血热（DHF）或登革休克综合征（DSS）。RF组的7天生存率为61.5%（8/13），而非RF组为96.4%（81/84）（<0.001）。当需要血管活性药物支持的患者比例在RF队列中显著更高时（RF组和非RF组分别为70%和14%，<0.001），两组队列中机械通气的需求（15%对11%，P = 0.67）相当。
DHF/DSS是登革热感染患者发生ARF的独立危险因素。这些儿童一旦发生RF，死亡率很高。
