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热带急性发热性疾病相关急性肾损伤的临床特征

Clinical Characteristics of Acute Kidney Injury Associated with Tropical Acute Febrile Illness.

作者信息

Omar Fardosa Dahir, Phumratanaprapin Weerapong, Silachamroon Udomsak, Hanboonkunupakarn Borimas, Sriboonvorakul Natthida, Thaipadungpanit Janjira, Pan-Ngum Wirichada

机构信息

Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand.

Faculty of Medicine and Health Sciences, SIMAD University, Mogadishu 2526, Somalia.

出版信息

Trop Med Infect Dis. 2023 Feb 27;8(3):147. doi: 10.3390/tropicalmed8030147.

Abstract

Tropical acute febrile illness (TAFI) is one of the most frequent causes of acute kidney injury (AKI). The prevalence of AKI varies worldwide because there are limited reports available and different definitions are used. This retrospective study aimed to determine the prevalence, clinical characteristics, and outcomes of AKI associated with TAFI among patients. Patients with TAFI were classified into non-AKI and AKI cases based on the Kidney Disease Improving Global Outcomes (KDIGO) criteria. Of 1019 patients with TAFI, 69 cases were classified as having AKI, a prevalence of 6.8%. Signs, symptoms, and laboratory results were significantly abnormal in the AKI group, including high-grade fever, dyspnea, leukocytosis, severe transaminitis, hypoalbuminemia, metabolic acidosis, and proteinuria. 20.3% of AKI cases required dialysis and 18.8% received inotropic drugs. Seven patients died, all of which were in the AKI group. Risk factors for TAFI-associated AKI were being male (adjusted odds ratio (AOR) 3.1; 95% CI 1.3-7.4), respiratory failure (AOR 4.6 95% CI 1.5-14.1), hyperbilirubinemia (AOR 2.4; 95% CI 1.1-4.9), and obesity (AOR 2.9; 95% CI 1.4-6). We recommend clinicians investigate kidney function in patients with TAFI who have these risk factors to detect AKI in its early stages and offer appropriate management.

摘要

热带急性发热性疾病(TAFI)是急性肾损伤(AKI)最常见的病因之一。由于现有报告有限且使用的定义不同,AKI在全球的患病率各不相同。这项回顾性研究旨在确定患者中与TAFI相关的AKI的患病率、临床特征和结局。根据改善全球肾脏病预后组织(KDIGO)标准,将TAFI患者分为非AKI和AKI病例。在1019例TAFI患者中,69例被分类为患有AKI,患病率为6.8%。AKI组的体征、症状和实验室检查结果明显异常,包括高热、呼吸困难、白细胞增多、严重转氨酶升高、低白蛋白血症、代谢性酸中毒和蛋白尿。20.3%的AKI病例需要透析,18.8%接受了血管活性药物治疗。7例患者死亡,均在AKI组。TAFI相关AKI的危险因素包括男性(校正比值比[AOR] 3.1;95%可信区间[CI] 1.3 - 7.4)、呼吸衰竭(AOR 4.6,95% CI 1.5 - 14.1)、高胆红素血症(AOR 2.4;95% CI 1.1 - 4.9)和肥胖(AOR 2.9;95% CI 1.4 - 6)。我们建议临床医生对有这些危险因素的TAFI患者进行肾功能检查,以便在早期阶段检测出AKI并提供适当的治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fdd/10056292/de8fcdf91e56/tropicalmed-08-00147-g001.jpg

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