Clinical Study of Critical Patients with Hemorrhagic Fever with Renal Syndrome Complicated by Acute Respiratory Distress Syndrome

Abstract

ObjectivesThe aim of this study was to investigate the clinical characteristics and outcomes of critical patients with hemorrhagic fever with renal syndrome (HFRS) complicated by acute respiratory distress syndrome (ARDS).Materials and MethodsTo observe the demographic, epidemiological and clinical characteristics, and to explore the predictive effects for prognosis in laboratory findings, we conducted a detailed retrospective analysis of clinical records for critical patients with HFRS complicated by ARDS, treated at the center for infectious diseases, Tangdu Hospital, between January 2008 and December 2012.ResultsA total of 48 critical patients with laboratory confirmed HFRS accompanied by ARDS were enrolled in the study, including 27 survivors and 21 non-survivors, with a fatality rate of 43.75%. Thirty-one individuals (64.6%) contracted HFRS between the months of September and December. The non-survivors tended to have lower incidence of overlapping phase (P = 0.025). There were no obvious differences in the needs for mechanical ventilation (MV) and renal replacement therapy (RRT), except for the need for vasoactive drugs between the survivors and non-survivors (P = 0.001). The non-survivors were found to have higher frequencies of encephalopathy, refractory shock and multiple organ dysfunction syndrome (MODS), lower incidences of acute renal failure (ARF) and secondary hypertension (P<0.05). The non-survivors tended to have lower levels of serum creatinine (Scr) (P<0.001) and fibrinogen (Fib) (P = 0.003), higher incidences of prolonged prothrombin time (PT) (P = 0.006) and activated partial thromboplastin time (APTT) (P = 0.020) and higher levels of aspartate aminotransferase (AST) (P = 0.015), and the laboratory parameters mentioned above reached statistical significance for predicting prognosis (P<0.05).ConclusionThe high mortality rate of critical patients with HFRS complicated by ARDS emphasizes the importance of clinicians’ alertness and timely initiation of systemic supportive therapy.

Effects of Smilaxchinoside A and Smilaxchinoside C, Two Steroidal Glycosides from Smilax riparia, on Hyperuricemia in a Mouse Model

“…Our data of serum Cr and BUN in general supports the effects of the two compounds on the levels of serum UA. It has been reported that serum Cr levels are associated with renal dysfunction (Hoffmann et al, 2010;Adibelli et al, 2012;Du et al, 2014), and our data showed that smilaxchinosides A and C possessed potent activities in the reduction of hyperuricemia-induced renal dysfunction.…”

“…Serum Cr and BUN levels can be associated with renal dysfunction. Renal damage can be accompanied by an increase in serum Cr and BUN indicating reduced urea and Cr clearance (Hoffmann et al, 2010;Adibelli et al, 2012;Du et al, 2014). Compared with the model group, the levels of serum Cr and BUN were suppressed significantly (both p < 0.01) by smilaxchinosides A and C. Moreover, smilaxchinosides A and C treatment at the dose of 10 mg/kg could significantly increase the renal UA handling parameter FEUA (both p < 0.05) and can enhance UA excretion.…”

HMGB‐1 as a Novel Predictor of Disease Severity and Prognosis in Patients with Hemorrhagic Fever with Renal Syndrome

“…Hemorrhagic fever with renal syndrome (HFRS) is a rodent-borne disease that is caused by Hantavirus (HV), with major clinical characteristics of fever, hemorrhage, hypotension, and renal damage [ 1 , 2 ]. The typical disease progresses through five phases: febrile, hypotensive, oliguric, diuretic, and convalescent [ 3 , 4 ]. China is the most severe endemic area of HFRS in the world, with a high incidence rate in the last ten years [ 5 ].…”

Elevated Soluble CD163 Plasma Levels Are Associated with Disease Severity in Patients with Hemorrhagic Fever with Renal Syndrome

“…HFRS is endemic in all 33 provinces of the People's Republic of China, where it is a significant public health problem, in which 20,000–50,000 human cases are diagnosed annually [3] . Notably, Xi'an city, which is the central district of the Shaanxi province, had an increasing HFRS incidence and mortality rate due to HFRS over the last three years [4] . There are five successive clinical phases in typical HFRS patients.…”