Clinical course of dengue fever and its impact on renal function in renal transplant recipients and patients with chronic kidney disease

• Published in: Nephrology (Carlton, Vic.) Vic.), 2019-05, Vol.24 (5), p.564-568
• Main Authors: Thomas, E.T Arun, George, Jacob, Sruthi, Devi, Vineetha, N. S., Gracious, Noble
• Format: Article
• Language: English
• Subjects: acute kidney injury; Adult; Case-Control Studies; chronic kidney disease; Dengue - complications; Dengue - diagnosis; Dengue - virology; Dengue fever; Disease Progression; Female; Fever; Graft Survival; Health risk assessment; Hemodialysis; Hemoglobin; Humans; India; Kidney - physiopathology; Kidney diseases; Kidney transplantation; Kidney Transplantation - adverse effects; Male; Middle Aged; mosquito‐borne viral infection; Prognosis; Prospective Studies; Questionnaires; Renal Dialysis; Renal function; Renal Insufficiency, Chronic - complications; Renal Insufficiency, Chronic - diagnosis; Renal Insufficiency, Chronic - physiopathology; Renal Insufficiency, Chronic - therapy; renal transplantation; Risk Assessment; Risk Factors; Severity of Illness Index; Time Factors; Viral diseases; Young Adult
• ISSN: 1320-5358; 1440-1797
• DOI: 10.1111/nep.13265

ABSTRACT Aim Dengue fever is a mosquito‐borne viral disease endemic in many tropical and sub‐tropical countries. There are only limited data in the literature about dengue fever in renal transplant recipients and patients with chronic kidney disease. This study compares the clinical course of dengue fever and its impact on renal function in renal transplant recipients, patients with chronic kidney disease and patients with normal baseline renal function. Methods An observational study was conducted from 1 May to 31 July 2017, at a tertiary care centre of South India. A major epidemic of dengue had occurred during the study period. Twelve renal transplant recipients, 22 patients with CKD and 58 patients with normal baseline renal function (control group) admitted with dengue fever were prospectively studied. Results Nadir WBC count was lowest in renal transplant recipients (2575 ± 1187/mm3), [P < 0.001]. Renal transplant recipients took more time for normalization of platelet count (6 ± 4.5 days), [P < 0.001]. All 22 patients with CKD and 11 of 12 renal transplant recipients had worsening of renal function whereas only 17 of 58 patients in the control group had worsening [P < 0.001]. Sixteen patients with CKD, one renal transplant recipient and none among the control group required haemodialysis [P < 0.001]. Dialysis requiring patients had more haemoconcentration (52.5 ± 19.9% increase in haemoglobin), [P < 0.001]. Seven patients with CKD were dialysis dependent at the end of 2 weeks. Conclusion Clinical features of dengue fever were different in renal transplant recipients and patients with CKD. Severe worsening of renal function was common in CKD patients. Worsening of renal function in renal transplant recipients was less severe and transient. Summary at a Glance Clinical features of dengue fever infection are different in renal transplant recipients and in patients with CKD. This paper showed that severe worsening of renal function is common in CKD patients. Worsening of renal function in renal transplant recipients is less severe and transient.