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首页> 外文期刊>Birdem Medical Journal >Risk factors for acute kidney injury among patients with chikungunya: a multi-center experience from the 2017 chikungunya outbreak in Dhaka, Bangladesh
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Risk factors for acute kidney injury among patients with chikungunya: a multi-center experience from the 2017 chikungunya outbreak in Dhaka, Bangladesh

机译：基孔肯雅热患者急性肾损伤的危险因素：孟加拉国达卡2017年基孔肯雅热疫情的多中心经验

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Background: Chikungunya is an emerging viral infection in Bangladesh. This self-limiting febrile illness may have acute life-threating features including cardiomyopathy and encephalitis. Acute kidney injury (AKI) is less well described complication of chikungunya. This study was designed to evaluate risk factors for AKI among patients with chikungunya virus infection.Methods: This case-control study was done in 3 different centers in Dhaka, Bangladesh from July to October 2017. Adult patients (18 years) with confirmed diagnosis of chikungunya were included in this study. AKI was diagnosed as per Kidney Disease: Improving Global Outcomes (KDIGO) Clinical Practice Guideline for Acute Kidney Injury. Patients suffering from chikungunya complicated by AKI were cases and those without AKI were controls.Results: Total patients were 107 (male 61) with a mean age of 35.6 (range 19-84) years. Common comorbidities were diabetes mellitus (DM) (20.6%), hypertension (17.8%) and chronic kidney disease (CKD) (12.1%). Common presentations included fever (86.9%) or recent history of fever (13.1%), joint pain (88.8%), rash (23.4%), pruritus (15.9%), gastro-intestinal (GI) features like diarrhea and/or vomiting (28%), lymphadenopathy (12.1%), gum swelling/oral ulcer (4.1%) and oedema (8.4%). Fourteen (13.1%) patients required hospitalization. Eleven (10.3%) cases were complicated by AKI. Among the risk factors for AKI, comorbidities like DM (OR 28.73, 95% CI 5.57-148.10, p 0.0001) and CKD (OR 31.0, 95% CI 2.94-326.7, p 0.0001), GI features (OR 16.07, 95% CI 3.22-80.14, p 0.0007), requirement of hospitalization (OR 23.10, 95% CI 2.37-226.31, p 0.0001) and use of angiotensin converting enzyme inhibitors/angiotensin receptor blockers (ACEIs/ARBs) (OR 6.65, 95% CI 1.77-24.98, p 0.005) were significant.Conclusions: One-tenth of adult patients suffering from chikungunya were complicated by AKI in this study. DM, CKD, diarrhea and/or vomiting, hospitalization and use of ACEIs/ARBs appeared as significant risk factors for AKI.
机译：背景：基孔肯雅热是孟加拉国正在出现的病毒感染。这种自限性的高热疾病可能具有危及生命的急性特征，包括心肌病和脑炎。基孔肯雅热的急性肾损伤（AKI）较少被描述。该研究旨在评估基孔肯雅病毒感染患者中AKI的危险因素。方法：本病例对照研究于2017年7月至2017年10月在孟加拉国达卡的3个不同中心进行。成年患者（> 18岁）确诊本研究包括基孔肯雅热的诊断。根据肾脏疾病：急性肾脏损伤临床实践指南（KDIGO）诊断AKI。结果：基孔肯雅热合并AKI的患者为对照组，无AKI的患者为对照组。结果：患者共107例（男性61例），平均年龄35.6岁（19-84岁）。常见合并症是糖尿病（DM）（20.6％），高血压（17.8％）和慢性肾脏病（CKD）（12.1％）。常见表现包括发烧（86.9％）或近期发烧史（13.1％），关节痛（88.8％），皮疹（23.4％），瘙痒（15.9％），胃肠道（GI）特征如腹泻和/或呕吐（28％），淋巴结病（12.1％），牙龈肿胀/口腔溃疡（4.1％）和水肿（8.4％）。十四名（13.1％）患者需要住院。 AKI并发11例（10.3％）。在AKI的危险因素中，合并症如DM（OR 28.73，95％CI 5.57-148.10，p 0.0001）和CKD（OR 31.0，95％CI 2.94-326.7，p <0.0001），GI特征（OR 16.07，95 ％CI 3.22-80.14，p 0.0007），住院要求（OR 23.10，95％CI 2.37-226.31，p <0.0001）和使用血管紧张素转化酶抑制剂/血管紧张素受体阻滞剂（ACEIs / ARBs）（OR 6.65，95 ％CI 1.77-24.98，P = 0.005）。结论：本研究中十分之一的成人患基孔肯雅热并发AKI。 DM，CKD，腹泻和/或呕吐，ACEI / ARB的住院和使用似乎是AKI的重要危险因素。

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