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Abstract: PO2297

CKD Among Patients with Dengue: A Comorbidity That Increases Hospitalization and Mortality

Session Information

Category: CKD (Non-Dialysis)

  • 2101 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

  • Silva Junior, Geraldo B., Universidade de Fortaleza, Fortaleza, CE, Brazil
  • Jereissati, Ana Amelia Reis, Universidade de Fortaleza, Fortaleza, CE, Brazil
  • Pinto, Jose Reginaldo, Universidade de Fortaleza, Fortaleza, CE, Brazil
  • Ramalho, Janaina de Almeida Mota, Universidade de Fortaleza, Fortaleza, CE, Brazil
  • Meneses, Gdayllon Cavalcante, Universidade Federal do Ceara, Fortaleza, CE, Brazil
Background

Dengue virus is one of the most important neglected tropical diseases in the world, with varying manifestations, including kidney involvement. The aim of this study was to investigate chronic kidney disease (CKD) and its association with outcomes among patients with dengue.

Methods

A cross-sectional study was conducted in Ceará State, northeast Brazil, in the period from January 2015 to December 2017, including all confirmed cases of dengue through clinical, epidemiology and laboratory tests (IgM specific antibodies or RT-PCR). We have made a comparison between patients with and without CKD, defined according to the KDIGO guidelines.

Results

A total of 161,880 patients were included. Patients with CKD were older (41±22 vs. 35±21 years, p<0.001), predominantly female (62 vs. 57%, p=0.004) and presented higher frequency of majority of symptoms and signs (fever: 89 vs. 86%, p=0.01; myalgia: 76 vs. 67%, p<0.001; rash: 35 vs. 22%, p<0.001; nausea: 42 vs. 23%, p<0.001). The most common comorbidities were hypertension and diabetes, which are also the most common causes of CKD (51 vs. 3.3% / 42 vs. 1.3%, p<0.001). Independent factors associated with CKD were: hematological disease (OR 8.08), auto-immune disease (OR 7.73), peptic ulcer disease (OR 7.19), hypertension (OR 5.06), diabetes (OR 2.57), leukopenia (OR 1.87), arthritis (OR 1.70), back pain (OR 1.43), petechia (OR 1.33) and nausea (OR 1.26). Need of hospitalization was significantly more frequent among the group with CKD (12.3% vs. 2.2%, p<0.001), and mortality was higher among CKD patients (2.2% vs. 0.1%, p<0.001), Figure 1.

Conclusion

CKD aggravates dengue severity, including the need of hospitalization and increased mortality. Patients with CKD and dengue should be carefully monitored, especially in epidemic periods.

Figure 1. Hospitalization need and mortality rate according to the presence of chronic kidney disease (CKD) in patients with dengue in Fortaleza, Brazil, 2015-2017.

Funding

  • Government Support – Non-U.S.