A study of incidence and outcome of acute kidney injury in common undifferentiated febrile illnesses

Background: Patients presenting with acute undifferentiated febrile illness may have delay in diagnosis due to nonspecific symptoms and signs. Kidney injury in these patients can cause detrimental effect on their prognosis and hence early diagnosis is warranted.Methods: This is an observational prospective study conducted in the Department of Medicine at Christian Medical College and Hospital, Ludhiana for a period of one year from 1st November 2014 till 31st October 2015.Results: Among the 532 patients acute febrile illness included in the study, 437(82.1%) were diagnosed with dengue fever. A total of 190(35.7%) patients were diagnosed to have AKI. The incidence of AKI in specific diseases was found to be the highest in Malaria 8(61.5%) out of 13 patients). In AKI, majority of them were in the risk category with 97(51.0%). A total of 26(13.6%) patients with AKI required Hemodialysis. Among the 190 patients who had AKI 43(22.6%) died.Conclusions: Dengue was the most common acute febrile illness. Among the patients with acute kidney injury majority were in the risk category with 97(18.2%). 326(61.2%) patients were males with a male to female ratio was found to be 1.5: 1. Dengue with acute kidney injury had the most proportion of patients in the risk and injury category and malaria with acute kidney injury having the highest proportion in failure category. The highest incidence of patients with AKI requiring hemodialysis was seen in scrub typhus. Leptospirosis with AKI had the highest proportion of mortality. The failure category had the highest proportion of mortality.

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The Revelations of Acute Kidney Injury in Cases of Acute Febrile Illness – A Hospital Based Observational Study from North Eastern India

Advancements in Journal of Urology and Nephrology ◽

10.33140/ajun.02.01.04 ◽

2020 ◽

Vol 2 (1) ◽

Keyword(s):

Acute Kidney Injury ◽

Serum Creatinine ◽

Urine Volume ◽

Kidney Injury ◽

Febrile Illness ◽

Hospitalized Patients ◽

Acute Febrile Illness ◽

Medical College ◽

Definition Of ◽

Unexpected Outcome

Background: Clinicians across the globe refer to the published KDIGO definition of Acute Kidney Injury (AKI) as one of the following: • An increase in serum creatinine by ≥0.3 mg/dl (≥26.5 µmol/l) within 48 hrs • An increase in serum creatinine to ≥1.5 times baseline within the previous 7 days • Urine volume <0.5 ml/kg/h for 6 hrs Acute febrile illnesses are a common cause of AKI in hospitalized patients. The present study was undertaken to evaluate the incidence of AKI in patients presenting with acute febrile illness and also study the different etiological factors responsible for acute febrile illness. Materials and Methods: The study included 200 patients of acute febrile illness admitted in Silchar Medical College And Hospital in the Department of Medicine over a period of 24 months. The data regarding the various causes such as the etiology of fever, kidney function tests and other parameters of the cases were obtained and analyzed using simple statistical methods. Results and Observations: A total of 52 patients (26%) with acute febrile illness due to etiologies like Leptospirosis, Falciparum Malaria, Enteric fever, Dengue, Scrub Typhus, and mixed Malaria, etc developed AKI out of the 200 admitted cases presenting with acute febrile illness. Conclusion: The incidence of AKI is common in hospitalized patients of acute febrile illness and a thorough evaluation and detailed clinicobiochemical monitoring of the patients are necessary as it has varied etiology and often lead to an unfavorable or even unexpected outcome.

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Scrub Typhus in Children

Journal of Nepal Paediatric Society ◽

10.3126/jnps.v38i1.18659 ◽

2018 ◽

Vol 38 (1) ◽

pp. 59-62

Author(s):

Madiha Zainab ◽

Atul Kumar Gupta ◽

Suparna Guha

Keyword(s):

Acute Kidney Injury ◽

Scrub Typhus ◽

Kidney Injury ◽

Febrile Illness ◽

Acute Febrile Illness ◽

Common Complication ◽

Orientia Tsutsugamushi ◽

Pain Abdomen ◽

One Year ◽

High Index Of Suspicion

Introduction: Scrub typhus is an acute febrile illness caused by infection with rickettsial bacilli Orientia tsutsugamushi. This was a retrospective observational study to study the clinical profile of paediatric scrub typhus, its associated complications and response to treatmentMaterial and Methods: Record files of all patients diagnosed with positive Weil felix (OXK>1:80) and Scrub IgM positive over a period of one year were analysed. Total of 10 cases were diagnosed as scrub with median age of presentation 4.1 years.Results: Fever was present in all followed by pain abdomen (50%), rash. Anaemia (90%), lymphadenopathy (70%) hepatomegaly (100%), Leukopenia was present in those cases with fever <1 week while leucocytosis was found thereafter. Most common complication were hepatitis (100%) shock (50%), acute kidney injury (AKI) 30%, DIC in 20% cases. Secondary HLH was found in 20% and pancarditis in one case. All the cases showed dramatic response to doxycycline.Conclusion: So a high index of suspicion is required to diagnose scrub and early initiation of treatment is essential to prevent mortality from the disease.

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Acute Kidney Injury in Patients of Intensive Care Unit

Anwer Khan Modern Medical College Journal ◽

10.3329/akmmcj.v8i1.31656 ◽

2017 ◽

Vol 8 (1) ◽

pp. 38-44

Author(s):

Nazneen Mahmood ◽

Md Fazlur Rahman ◽

Md Mostafizur Rahman ◽

SM Hossain Shahid ◽

Md Mahmudur Ahman Siddiqui

Keyword(s):

Intensive Care Unit ◽

Acute Kidney Injury ◽

Intensive Care ◽

Kidney Injury ◽

Type I ◽

College Hospital ◽

Cross Sectional ◽

Female Ratio ◽

Failure Group ◽

Medical College

Background: Acute Kidney Injury (AKI) is a common complication in patients admitted to the intensive care unit (ICU) and numerous causes are responsible for its development. The aim of the present study is to assess the incidence, risk factors, and outcome of patients who develop AKI in our ICU.Methodology: This study was conducted by the Department of Nephrology, Anwer Khan Modern Medical College Hospital (AKMMCH), a tertiary level center of Dhaka, during the period of January 2015 to December 2015. This is a Cross Sectional Descriptive type of Observational study on patients of Acute Kidney Injury (AKI) admitted to Intensive Care Unit (ICU) of AKMMCH.Result: A total number of 271 patients were admitted. Out of 271 patients, 59 (21.77%) patients with AKI who met our study requirements were included in the study and were evaluated. Among 59 patients 32 (54.23%) were males and 27 (45.77%) were females, with a male to female ratio of 1.19:1. The cause of admission were Diabetes mellitus with complication 11 (18.64%), Hepato-renal syndrome 10 (16.94%), Malignancy 7 (11.86%), Septicaemia 6 (10.18% ), Pneumonia 6 (10.18%), Intra-uterine death (IUD) 5 (8.48%) and others (Acute Myocardial Infarction, Non ST segment Elevated MI, Cerebro Vascular Disease, Gullain Burre Syndrome, Laparatomy, Type I and Type II Respiratory failure) 14 (23.72%). According to RIFLE's criteria most of the patients were from Injury group 32 (54.23%). Next to this, was Risk group 17 (28.83%) and in Failure, Loss and ESRD group were 7 (11.86%), 1(1.69%) and 2 (3.39%) accordingly. Regarding biochemical abnormality, mean Serum creatinine was 3.68 ± 2.15 and that of Urine output, HbA1C and HCO3 level ( in ABG ) were 4.57 ± 8.89, 6.91±1.4 and 17.14 ± 3.8 respectively. Out of 59 patients 10 (16.95%) needed Haemodialysis. According to RIFLE's criteria 7 (70%) were from Failure group, 1 patient from Loss group and 2 from ESRD group who received haemodialysis. 72.88% (43) patients improved, out of which 57.62% (34) got discharged from ICU after full recovery. 6.48% (4) patients expired and 3.38% (2) turned into ESRD and advised for regular haemodialysis.Conclusion: The incidence of AKI is high in patients admitted to ICU, and the development of AKI is associated with poor outcome and reduced survival. AKI significantly increases the duration of ICU stay, and this is likely to add to the healthcare burden. Age, gender or the presence of comorbidities do not appear to influence the incidence of AKI in our ICU patients.Anwer Khan Modern Medical College Journal Vol. 8, No. 1: Jan 2017, P 38-44

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Clinical Profile of Acute Kidney Injury in Acute Febrile Illness with Thrombocytopenia

Journal of Medical Science And clinical Research ◽

10.18535/jmscr/v6i8.77 ◽

2018 ◽

Vol 6 (8) ◽

Author(s):

Dr Arjun. V. A ◽

Keyword(s):

Acute Kidney Injury ◽

Kidney Injury ◽

Febrile Illness ◽

Clinical Profile ◽

Acute Febrile Illness

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Assessment of urinary interleukin-18 in the early post-burn period to predict acute kidney injury of various degrees of burn patients

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20220001 ◽

2022 ◽

Author(s):

Sharif Qamar Uddin ◽

M. Nazrul Islam ◽

M. Nizamuddin Chowdhury ◽

Nizam Uddin Ahmed Chowdhury ◽

Mohammad Zahir Uddin ◽

...

Keyword(s):

Acute Kidney Injury ◽

Predictive Value ◽

Kidney Injury ◽

Study Data ◽

Burn Patients ◽

Interleukin 18 ◽

College Hospital ◽

Female Ratio ◽

Medical College ◽

Sensitivity Specificity

Background: Early detection of acute kidney injury (AKI) in burn-injured patients can help modify the treatment to prevent progression of acute renal failure and reduce the need for renal replacement therapy. The aim of the study was to evaluate urinary interleukin-18 in the early post-burn period to predict the AKI for the various degrees of burn patients.Methods: This prospective observational study was conducted in the department of nephrology, Dhaka medical college in collaboration with burn and plastic surgery unit of the same medical college hospital, from July 2017 to June 2018 for a period of one year. The 48 burn patients (Age>18 years) who attended in the burn unit of Dhaka medical college, Dhaka of both sexes were enrolled in this study. Data were analyzed by using SPSS 22.0. A value of p<0.05 was considered statistically significant for all tests.Results: In this study, mean age of the burn patients was 32.41±10.59 years. Male female ratio was 3.36:1. Urinary IL-18 in diagnosis of AKI showed accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were 93.8%, 91.7%, 94.4%, 84.6% and 97.1% respectively. AUC for urinary IL-18 at admission was 0.968 (CI, 0.921-1.000) and AUC for serum creatinine at admission was 0.937 (CI, 0.871-1.000). Conclusions: According to Kappa value, AUC and sensitivity and specificity urinary IL-18 is a good biomarker in predicting of early AKI in burn patients.

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Acute kidney injury in tropical acute febrile illness in a tertiary care centre--RIFLE criteria validation

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfq477 ◽

2010 ◽

Vol 26 (2) ◽

pp. 524-531 ◽

Cited By ~ 46

Author(s):

G. Basu ◽

A. Chrispal ◽

H. Boorugu ◽

K. G. Gopinath ◽

S. Chandy ◽

...

Keyword(s):

Acute Kidney Injury ◽

Tertiary Care ◽

Kidney Injury ◽

Febrile Illness ◽

Acute Febrile Illness ◽

Care Centre ◽

Tertiary Care Centre ◽

Rifle Criteria

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117 A PROSPECTIVE STUDY OF ACUTE KIDNEY INJURY IN TROPICAL ACUTE FEBRILE ILLNESS IN WEST PAHANG, MALAYSIA

Kidney International Reports ◽

10.1016/j.ekir.2017.06.061 ◽

2017 ◽

Vol 2 (4) ◽

pp. S16

Author(s):

Wan Mohd Rasis Wan Ahmad Kamil ◽

Rafidah Abdullah ◽

Alif Adlan Mohd Thabit ◽

Mohd Ramadhan Mohd Din ◽

Siti Sanaa Wan Azman ◽

...

Keyword(s):

Acute Kidney Injury ◽

Prospective Study ◽

Kidney Injury ◽

Febrile Illness ◽

Acute Febrile Illness ◽

A Prospective Study

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A Clinical Study of Acute Kidney Injury in Tropical Acute Febrile Illness

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2016/19393.8243 ◽

2016 ◽

Author(s):

Jayalal Jayapalan Nair

Keyword(s):

Acute Kidney Injury ◽

Clinical Study ◽

Kidney Injury ◽

Febrile Illness ◽

Acute Febrile Illness

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The potential nephrotoxic effect of single tablet of 15 mg primaquine in G6PD deficient Hadoti region population of India

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20170899 ◽

2017 ◽

Vol 4 (2) ◽

pp. 605 ◽

Cited By ~ 1

Author(s):

Vikash Khandelia ◽

Pavankumar Pyarsabadi ◽

Umashankar Nama ◽

Saurabh Chittora ◽

Yogesh Swami ◽

...

Keyword(s):

Acute Kidney Injury ◽

Renal Function ◽

Kidney Injury ◽

Febrile Illness ◽

Medical College ◽

Prior Testing ◽

Health Care Burden ◽

Glucose 6 Phosphate Dehydrogenase ◽

Prevention Of Relapse ◽

Significant Health

Primaquine is used in prevention of relapse of plasmodium vivax and ovale. It is known to cause haemolysis induced acute kidney injury in patients with glucose-6-phosphate dehydrogenase (G-6-PD) enzyme deficiency. Primaquine is widely used in the remote areas of Hadoti region of India by many non-registered practitioners for treatment of febrile illnesses without prior testing of G-6-PD status. Due to this practice, many patients land up with the grave consequences with significant health care burden. We report 8 such cases, which were referred to our hospital, New hospital medical college, Kota, Rajasthan, India. Our study included a series of 8 cases which were referred to our hospital with significantly deranged renal function test due to use of primaquine without prior testing of G-6-PD status. Routine blood investigations including renal function tests and G-6-PD status were measured. In our study, we found that patients with febrile illness and G-6-PD deficiency developed acute kidney injury even with a single tablet of 15 mg of primaquine. The use of even a single dose of 15 mg primaquine may not be safe in population of Hadoti region of India. Hence they should not be exposed to primaquine without prior G-6-PD testing.

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