Prevalence, Characteristics, and Factors Associated with Acute Kidney Injury among Adult Dengue Patients in Vietnam

The incidence of dengue has been reported worldwide and is increasing rapidly in recent decades. With the geographical spread of dengue illness, clinical manifestations of the disease have also been reported to be more complicated and unpredictable.1 In addition to shock and severe bleeding that have been reported as the main causes of death from the disease, several unusual manifestations, including neurological, hepatic, and renal, have also been reported in relation to severity and mortality.2 Acute kidney injury (AKI) is considered infrequent complication of dengue patients; however, that increases the mortality of the disease.1,3,4 In the Southeast Asian countries where dengue has become a public health problem, there have been some reports about the risk of AKI in patients with dengue. This is also a problem that is recommended for more systematic study and more accurate clinical Acute kidney injury (AKI) is a serious and potentially lethal complication of dengue disease; however, the actual incidence in dengue patients in Vietnam is unknown. This study aimed to determine the prevalence, clinical and laboratory characteristics, and risk factors for AKI in adults with dengue. This is a multicenter, cross-sectional study conducted between January and December 2017 in 2,417 adult patients with dengue. Indicators of demographic, clinical, and laboratory findings were evaluated. The prevalence of dengue disease-associated AKI was 2.7% (64/2,417), and dengue patients with AKI had a higher mortality rate than patients without AKI (12.5% versus 0.6%; P < 0.01). Characteristics of AKI were more common in male gender (male: female was 6.1:1), a history of hypertension (7.8% versus 2.3%; P 0.02), the situations of hemoconcentration (hematocrit 0.01). Independent risk factors for AKI by multivariate analysis were male gender (odds ratio [OR]: 43.6; 95% CI: 2.4-810), severe dengue classification (OR: 25.7; 95% CI: 2-333), and creatine kinase 190 U/L (OR: 11.7; 95% CI: 1.1-122.4). The study results indicate a need to continue studying the association between AKI and mortality in dengue disease and the need for improved management of AKI with dengue.