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Acute kidney injury and tools for risk-stratification in 456 patients with hantavirus-induced nephropathia epidemica

Latus, Joerg ; Schwab, Matthias ; Tacconelli, Evelina ; Pieper, Friedrich-Michael ; Wegener, Daniel ; Rettenmaier, Bianka ; Schwab, Andrea ; Hoffmann, Larissa ; Dippon, Juergen ; Müller, Simon ; Fritz, Peter ; Zakim, David ; Segerer, Stephan ; Kitterer, Daniel ; Kimmel, Martin ; Gußmann, Karl ; Priwitzer, Martin ; Mezger, Barbara ; Walter-Frank, Birgit ; Corea, Angela ; Wiedenmann, Albrecht ; Brockmann, Stefan ; Pöhlmann, Christoph ; Alscher, M Dominik ; Braun, Niko

Nephrology, dialysis, transplantation, 2015-02, Vol.30 (2), p.245-251 [Periódico revisado por pares]

England

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Título:
Acute kidney injury and tools for risk-stratification in 456 patients with hantavirus-induced nephropathia epidemica
Autor: Latus, Joerg ; Schwab, Matthias ; Tacconelli, Evelina ; Pieper, Friedrich-Michael ; Wegener, Daniel ; Rettenmaier, Bianka ; Schwab, Andrea ; Hoffmann, Larissa ; Dippon, Juergen ; Müller, Simon ; Fritz, Peter ; Zakim, David ; Segerer, Stephan ; Kitterer, Daniel ; Kimmel, Martin ; Gußmann, Karl ; Priwitzer, Martin ; Mezger, Barbara ; Walter-Frank, Birgit ; Corea, Angela ; Wiedenmann, Albrecht ; Brockmann, Stefan ; Pöhlmann, Christoph ; Alscher, M Dominik ; Braun, Niko
Assuntos: Acute Kidney Injury - diagnosis ; Acute Kidney Injury - metabolism ; Acute Kidney Injury - virology ; Adult ; Biomarkers - metabolism ; C-Reactive Protein - metabolism ; Cross-Sectional Studies ; Female ; Hantavirus - pathogenicity ; Hemorrhagic Fever with Renal Syndrome - diagnosis ; Hemorrhagic Fever with Renal Syndrome - metabolism ; Hemorrhagic Fever with Renal Syndrome - virology ; Humans ; Male ; Middle Aged ; Odds Ratio ; Prospective Studies ; Proteinuria - diagnosis ; Proteinuria - metabolism ; Proteinuria - virology ; Risk Factors ; Severity of Illness Index ; Thrombocytopenia - diagnosis ; Thrombocytopenia - metabolism ; Thrombocytopenia - virology
É parte de: Nephrology, dialysis, transplantation, 2015-02, Vol.30 (2), p.245-251
Notas: ObjectType-Article-1
SourceType-Scholarly Journals-1
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Descrição: Puumala virus (PUUV) is the most common species of hantavirus in Central Europe. Nephropathia epidemica (NE), caused by PUUV, is characterized by acute kidney injury (AKI) and thrombocytopenia. The major goals of this study were to provide a clear clinical phenotyping of AKI in patients with NE and to develop an easy prediction rule to identify patients, who are at lower risk to develop severe AKI. A cross-sectional prospective survey of 456 adult patients with serologically confirmed NE was performed. Data were collected from medical records and prospectively at follow-up visit. Severe AKI was defined by standard criteria according to the RIFLE (Risk, Injury, Failure, Loss, End-stage kidney disease) classification. Fuller statistical models were developed and validated to estimate the probability for severe AKI. During acute NE, 88% of the patients had AKI according to the RILFE criteria during acute NE. A risk index score for severe AKI was derived by using three independent risk factors in patients with normal kidney function at time of diagnosis: thrombocytopenia [two points; odds ratios (OR): 3.77; 95% confidence intervals (CI): 1.82, 8.03], elevated C-reactive protein levels (one point; OR: 3.02; 95% CI: 1.42, 6.58) and proteinuria (one point; OR: 3.92; 95% CI: 1.33, 13.35). On the basis of a point score of one or two, the probability of severe AKI was 0.18 and 0.28 with an area under the curve of 0.71. This clinical prediction rule provides a novel and diagnostically accurate strategy for the potential prevention and improved management of kidney complications in patients with NE and, ultimately, for a possible decrease in unnecessary hospitalization in a high number of patients.
Editor: England
Idioma: Inglês

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Acute kidney injury and tools for risk-stratification in 456 patients with hantavirus-induced nephropathia epidemica

England

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