Department of Nephrology, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), Porur, Chennai, Tamil Nadu, India.
Saudi J Kidney Dis Transpl. 2020 Jul-Aug;31(4):759-766. doi: 10.4103/1319-2442.292309.
Influenza A (H1N1) infection in 2009 spread rapidly all over the world. Mortality was high in patients with H1N1-associated acute kidney injury (AKI). We estimated the incidence, risk factors of AKI and mortality associated with H1N1 infection. This is a prospective observational study, including 158 adult patients with H1N1 infection confirmed with real-time reverse transcriptase-polymerase chain reaction conducted between August 2016 and September 2017. AKIN criteria were used to define AKI. Of 158 patients in this study, 112 were male and the mean age was 46.4. Fifteen patients (9.5%) were found to have AKI. The mean age was higher (56.13 ± 10.02) in the AKI group compared to non-AKI (45.48 ± 16.26) (P = 0.007). Presence of shock, multiple organ dysfunction syndrome (MODS), ventilatory support were observed more in the AKI group (P = 0.000). Among AKI patients, the requirement of dialysis was more than 50% (n = 8/15, 53.3%). Eighteen patients died following H1N1 infection (11.4%).Shock (n = 8/18, 44.4%, P = 0.000), MODS (n = 13/18, 72.2%, P = 0.000), intensive care unit (ICU) care (n = 17/18, 94.4%, P = 0.000), ventilatory support (n = 18/18, 100% P = 0.000), AKI (n = 11/18, 61.1%, P = 0.000), and requiring dialysis (n = 7/18, 38.9%, P = 0.000) were significantly associated with mortality compared to patients who survived. The incidence of H1N1 AKI was 9.5%, with > 50% requiring dialysis. Risk factors for AKI included older age, underlying chronic kidney disease, presentation with sepsis, shock, MODS, ICU care, and mechanical ventilation. Mortality was high in patients with AKI compared to non-AKI patients.
2009 年甲型 H1N1 流感在全球迅速蔓延。与 H1N1 相关的急性肾损伤（AKI）患者死亡率较高。我们评估了与 H1N1 感染相关的 AKI 的发病率、危险因素和死亡率。这是一项前瞻性观察性研究，纳入了 2016 年 8 月至 2017 年 9 月间经实时逆转录-聚合酶链反应确诊的 158 例成人甲型 H1N1 感染患者。采用 AKIN 标准定义 AKI。在这项研究的 158 例患者中，112 例为男性，平均年龄为 46.4 岁。15 例（9.5%）患者出现 AKI。AKI 组的平均年龄（56.13 ± 10.02）高于非 AKI 组（45.48 ± 16.26）（P = 0.007）。AKI 组更易出现休克、多器官功能障碍综合征（MODS）和机械通气（P = 0.000）。在 AKI 患者中，需要透析的比例超过 50%（n = 8/15，53.3%）。18 例患者（11.4%）因 H1N1 感染而死亡。出现休克（n = 8/18，44.4%，P = 0.000）、MODS（n = 13/18，72.2%，P = 0.000）、重症监护病房（ICU）治疗（n = 17/18，94.4%，P = 0.000）、机械通气（n = 18/18，100%，P = 0.000）、AKI（n = 11/18，61.1%，P = 0.000）和需要透析（n = 7/18，38.9%，P = 0.000）的患者死亡率明显高于存活患者。H1N1 相关 AKI 的发病率为 9.5%，其中>50%需要透析。AKI 的危险因素包括年龄较大、合并慢性肾脏病、脓毒症、休克、MODS、ICU 治疗和机械通气。与非 AKI 患者相比，AKI 患者死亡率较高。
