Abstract

Background: Dengue was one of the top 10 probable health concerns to the world in 2019 according to the World Health Organization. Dengue fever has been associated with various types of renal manifestations such as proteinuria, hematuria, glomerulonephritis, and acute kidney injury (AKI). Hence, this prospective cross-sectional observational study was designed to analyze the frequency, characteristics, and clinical outcome of dengue fever in children with renal manifestations.
Materials & Methods: This was a cross sectional observational study done on 225 cases of children with dengue fever in the Department of pediatrics, SPMCHI hospital Sawai Man Singh Medical College, Jaipur. Data regarding the need for fluid resuscitation, colloid infusion, inotrope support, ventilatory requirement were collected. Creatinine values and urine output were noted and ‘Kidney Disease Improving Global Outcome 2012 (KDIGO)’ guideline was used to stage the acute kidney injury. Various renal manifestations of dengue will be studied and compared between the severity of dengue fever. Continuous variables were summarized as mean and standard deviation and were analyzed using independent sample t test for comparison between 2 groups and ANOVA test was used for comparison between multiple groups (>2 groups).
Results: Our study showed that Mean age of 225 children with dengue in present study was 7.98 ± 4.21 years. Male to female ratio was 1.06:1. Renal involvement was highest in patients with dengue shock syndrome (28.6%), followed by those with dengue hemorrhagic fever (18.4%) and was least in those with dengue fever (4.7%). This difference in incidence of renal involvement in relation to severity of dengue was found to best artistically significant (p<0.001). The duration of hospital stay was highest in patients with Failure p RIFLE criteria (11.5 ± 4.95 days), followed by injury category (7 ± 1.41 days) and was least in risk category (5± 0.89 days), and this difference was found to best artistically significant (p=0.019).
Conclusion: We concluded that renal involvement was more common in dengue shock syndrome. Transient proteinuria and hematuria have been detected in most patients with dengue fever. So a clinician who is dealing with dengue patients should have closed watched on renal functions so kidney injury can be avoid to some extent as well as the mortality in dengue.