Risk factors for acute kidney injury among patients with chikungunya: a multi-center experience from the 2017 chikungunya outbreak in Dhaka, Bangladesh

Authors

  • Shahana Zaman Junior Consultant, Cardiology, NICVD, Dhaka, Bangladesh
  • Muhammad Abdur Rahim Associate Professor, Nephrology, BIRDEM General Hospital, Dhaka, Bangladesh
  • Mehruba Alam Ananna Associate Professor, Nephrology, BIRDEM General Hospital, Dhaka, Bangladesh
  • Ishrat Jahan Assistant Registrar, Nephrology, BIRDEM General Hospital, Dhaka, Bangladesh
  • Tufayel Ahmed Chowdhury Registrar, Nephrology, BIRDEM General Hospital, Dhaka, Bangladesh
  • Sarwar Iqbal Professor, Nephrology, BIRDEM General Hospital, Dhaka, Bangladesh
  • Khwaja Nazim Uddin Professor, Internal Medicine, BIRDEM General Hospital, Dhaka, Bangladesh
  • Zafar Ahmed Latif Professor, Endocrinology and Director General, BIRDEM General Hospital, Dhaka, Bangladesh

DOI:

https://doi.org/10.3329/birdem.v9i3.43079

Keywords:

acute kidney injury, Bangladesh, chikungunya, Dhaka outbreak, risk factors.

Abstract

Background: Chikungunya is an emerging viral infection in Bangladesh. This self-limiting febrile illness may have acute life-threating features including cardiomyopathy and encephalitis. Acute kidney injury (AKI) is less well described complication of chikungunya. This study was designed to evaluate risk factors for AKI among patients with chikungunya virus infection.

Methods: This case-control study was done in 3 different centers in Dhaka, Bangladesh from July to October 2017. Adult patients (>18 years) with confirmed diagnosis of chikungunya were included in this study. AKI was diagnosed as per Kidney Disease: Improving Global Outcomes (KDIGO) Clinical Practice Guideline for Acute Kidney Injury. Patients suffering from chikungunya complicated by AKI were cases and those without AKI were controls.

Results: Total patients were 107 (male 61) with a mean age of 35.6 (range 19-84) years. Common comorbidities were diabetes mellitus (DM) (20.6%), hypertension (17.8%) and chronic kidney disease (CKD) (12.1%). Common presentations included fever (86.9%) or recent history of fever (13.1%), joint pain (88.8%), rash (23.4%), pruritus (15.9%), gastro-intestinal (GI) features like diarrhea and/or vomiting (28%), lymphadenopathy (12.1%), gum swelling/oral ulcer (4.1%) and oedema (8.4%). Fourteen (13.1%) patients required hospitalization. Eleven (10.3%) cases were complicated by AKI. Among the risk factors for AKI, comorbidities like DM (OR 28.73, 95% CI 5.57-148.10, p 0.0001) and CKD (OR 31.0, 95% CI 2.94-326.7, p <0.0001), GI features (OR 16.07, 95% CI 3.22-80.14, p 0.0007), requirement of hospitalization (OR 23.10, 95% CI 2.37-226.31, p <0.0001) and use of angiotensin converting enzyme inhibitors/angiotensin receptor blockers (ACEIs/ARBs) (OR 6.65, 95% CI 1.77-24.98, p 0.005) were significant.

Conclusions: One-tenth of adult patients suffering from chikungunya were complicated by AKI in this study. DM, CKD, diarrhea and/or vomiting, hospitalization and use of ACEIs/ARBs appeared as significant risk factors for AKI.

Birdem Med J 2019; 9(3): 193-196

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Published

2019-09-11

How to Cite

Zaman, S., Rahim, M. A., Ananna, M. A., Jahan, I., Chowdhury, T. A., Iqbal, S., Uddin, K. N., & Latif, Z. A. (2019). Risk factors for acute kidney injury among patients with chikungunya: a multi-center experience from the 2017 chikungunya outbreak in Dhaka, Bangladesh. BIRDEM Medical Journal, 9(3), 193–196. https://doi.org/10.3329/birdem.v9i3.43079

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Section

Original Articles