Universidade Federal do Ceará, Faculdade de Medicina, Programa de Pós-Graduação em Ciências Médicas, Departamento de Medicina Interna, Fortaleza, CE, Brazil.
Universidade de Fortaleza, Centro de Ciências da Saúde, Curso de Medicina, Fortaleza, CE, Brazil.
J Bras Nefrol. 2024 Jul-Sep;46(3):e20230168. doi: 10.1590/2175-8239-JBN-2023-0168en.
Arboviruses are endemic in several countries and represent a worrying public health problem. The most important of these diseases is dengue fever, whose numbers continue to rise and have reached millions of annual cases in Brazil since the last decade. Other arboviruses of public health concern are chikungunya and Zika, both of which have caused recent epidemics, and yellow fever, which has also caused epidemic outbreaks in our country. Like most infectious diseases, arboviruses have the potential to affect the kidneys through several mechanisms. These include the direct action of the viruses, systemic inflammation, hemorrhagic phenomena and other complications, in addition to the toxicity of the drugs used in treatment. In this review article, the epidemiological aspects of the main arboviruses in Brazil and other countries where these diseases are endemic, clinical aspects and the main laboratory changes found, including changes in renal function, are addressed. It also describes how arboviruses behave in kidney transplant patients. The pathophysiological mechanisms of kidney injury associated with arboviruses are described and finally the recommended treatment for each disease and recommendations for kidney support in this context are given.
虫媒病毒在多个国家流行,是一个令人担忧的公共卫生问题。其中最重要的疾病是登革热,自上世纪以来,巴西每年的登革热病例已达数百万例。其他引起公共卫生关注的虫媒病毒还有基孔肯雅热和寨卡热,这两种病毒都曾引发过近期的流行,黄热病也曾在我国引发过流行。与大多数传染病一样,虫媒病毒可通过多种机制影响肾脏。这些机制包括病毒的直接作用、全身炎症、出血现象和其他并发症,以及治疗中使用的药物的毒性。在这篇综述文章中,讨论了巴西和其他流行这些疾病的国家的主要虫媒病毒的流行病学方面、临床方面和主要实验室变化,包括肾功能变化。还描述了虫媒病毒在肾移植患者中的表现。描述了与虫媒病毒相关的肾脏损伤的病理生理机制,最后给出了每种疾病的推荐治疗方法和在这种情况下肾脏支持的建议。