Acute kidney injury in tropical acute febrile illness in a tertiary care centre--RIFLE criteria validation

Basu, Gopal; Chrispal, Anugrah; Boorugu, Harikishan; Gopal, Gopinath Kango; Chandy, Sara; Prakash, John A. J.; Thomas, Kurien; Abraham, Asha Mary; John, George

doi:10.1093/ndt/gfq477

Cited by 94 publications

(106 citation statements)

References 34 publications

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“…In this study, 35.8% of the patients developed AKI, which is consistent with findings in other studies where its incidence has been reported ranging from 10 to 60%. [32][33][34][35][36] Most of the patients had stage 1 and 2 AKI comprising of 66% and 33% respectively and only 1% of patients had stage 3 AKI.…”

Section: -33mentioning

confidence: 99%

Clinical presentation of scrub typhus during a major outbreak in central Nepal

Sedhain

Bhattarai²

2017

Asian J Med Sci

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Background: Scrub typhus, an emerging rickettsial disease caused by the organism Orientiatsutsugamushi, is associated with multi-organ involvement. We prospectively studied the clinical manifestations of the disease during a major outbreak in central part of Nepal. Aims and Objective: This study was carried out with an aim to analyze the clinical presentations, laboratory parameters, complications and outcomes of scrub typhus. Materials and Methods: A prospective observational study was conducted in the Department of Medicine in a tertiary teaching hospital. A total of 1398 patients admitted with acute febrile illness were subjected for Scrub Typhus Detect™ IgM ELISA test, among which 502 (35.90%) patients tested positive and were included in the study. Acute kidney injury was defined according to KDIGO guideline. Statistical analysis was done with SAS University Studio package using t-test for continuous variables and chi-square test for categorical variables. Results: Mean age of the patients was 30.37±18.81 years with 26.29% in the pediatric age group (<14 years). Females comprised of 55.98% of the patients. Majority (97.98%) of the patients were seen between July to November. Clinical presentations in the descending order of frequency were anorexia (55.18%), headache (53.39%), lymphadenopathy (15.73%), jaundice (13.35) and eschar (6.57%). Mean scrub typhus IgM ELISA value was 2.17. Leukocytosis was seen in 5.78% and thrombocytopenia in 66.73% of patients. Transaminitis was found in 80.68% of patients. Urinary abnormalities were recorded in 42.3% of patients. Acute kidney injury (AKI) was seen in 35.8% of patients followed by acute respiratory distress syndrome (24.1%), pneumonia (22.1%), shock (14.74%), neurologic manifestation (6.37%) and cardiac manifestations (4.38%). ICU admission was required for 18.73% of patients and 8.57% required ventilator support. Mortality rate was 1.79%. Conclusion: Scrub typhus, being an emerging vector borne infectious disease in Nepalese context, is associated with multiple organ involvement.

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Section: -33mentioning

confidence: 99%

Clinical presentation of scrub typhus during a major outbreak in central Nepal

Sedhain

Bhattarai²

2017

Asian J Med Sci

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“…In a study on 367 consecutively enrolled adult inpatients of a tertiary hospital in southern India, with tropical acute febrile illness due to scrub typhus, malaria, enteric fever, dengue, leptospirosis and undifferentiated acute febrile illness, the incidence of AKI was 41.1 % [1]. Scrub typhus accounted for the majority (51.2 %) of tropical acute febrile illnesses in this study.…”

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confidence: 64%

“…To the Editor: Tropical acute febrile illnesses have been described as important causes of acute kidney injury (AKI) in developing countries [1][2][3][4]. There is renewal of interest with emergence of such diseases in the developed countries and non-tropical regions as well, due to global warming and travel to tropics [5].…”

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confidence: 99%

Incidence and Etiology of Acute Kidney Injury in Southern India: Author’s Reply

Krishnamurthy

2013

Indian J Pediatr

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“…Most studies report an incidence of AKI of 10-40%, which is very similar to that of our results. 15,16,19,31,32 However, the slightly lower incidence of AKI noted in other studies is likely because of inclusion of patients outside the intensive care unit. In a small prospective observational study 32 of 100 critically ill patients from North India, Paudel et al reported 33% incidence of AKI based on AKIN criteria and very high mortality rate in patients with AKI (93.3%) as well as non-AKI patients (53.7%).…”

Section: Discussionmentioning

confidence: 86%

“…Very few studies have attempted to explore the epidemiology of AKI in India. [15][16][17][18][19][20] However, these studies have either evaluated specific patient population or included patients outside the ICU, pediatric patients or have not used RIFLE or AKIN criteria to define, stratify or prognosticate AKI. Hence, in this study we aim to explore the epidemiology of AKI using both the RIFLE and AKIN criteria and to determine the prognostic validity of these criteria in an Indian ICU.…”

Section: Introductionmentioning

confidence: 99%

Epidemiology, outcomes and validation of RIFLE and AKIN criteria in acute kidney injury (AKI) in critically ill patients: Indian perspective

Reddy¹,

Ravi²,

Dhanalakshmi³

et al. 2014

Renal Failure

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Although the epidemiology and the impact of Acute Kidney Injury on outcomes are wellknown in the Western literature, good data is lacking from India. Most studies published from India have not evaluated epidemiology of Acute Kidney Injury in the Intensive Care Unit setting and/or have not used validated criteria. In our observational study of 250 patients, admitted to a tertiary level ICU, we have explored the epidemiology of Acute Kidney Injury using both RIFLE and AKIN criteria and have validated them. We have also demonstrated that the severity of AKI is an independent predictor of mortality in critically ill patients. Our results are very much comparable to other studies and we feel that this study will remain as an epidemiological reference point for Indian clinicians dealing with AKI.

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Acute kidney injury in tropical acute febrile illness in a tertiary care centre--RIFLE criteria validation

Cited by 94 publications

References 34 publications

Clinical presentation of scrub typhus during a major outbreak in central Nepal

Clinical presentation of scrub typhus during a major outbreak in central Nepal

Incidence and Etiology of Acute Kidney Injury in Southern India: Author’s Reply

Epidemiology, outcomes and validation of RIFLE and AKIN criteria in acute kidney injury (AKI) in critically ill patients: Indian perspective

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