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Kidney Week

Abstract: SA-PO061

Study of Outcome of AKI in Scrub Typhus

Session Information

Category: Acute Kidney Injury

  • 102 AKI: Clinical‚ Outcomes‚ and Trials

Author

  • Patnaik, Aswini Prasad, Kalinga Institute of Medical Sciences, Bhubaneswar, Orissa, India
Introduction

Scrub typhus is one of the neglected tropical diseases in the world. Scrub typhus is a mite-borne infectious disease caused by the intracellular Gram-negative bacteria Orientia tsutsugamushi. The clinical prognosis of scrub typhus varies from mild-to-severe course. Renal involvement is not uncommon in scrub typhus1. Including acute renal failure, nephrotic syndrome and end-stage renal disease leading to long-term hemodialysis2. The risk factors and prognosis of AKI associated with scrub typhus have been poorly studied3.

Case Description

Aim: To study the incidence, outcome of AKI in scrub typhus. To study the requirement of renal replacement therapy. Material and Methods: The study was done in Kalinga Institute of Medical Sciences, Bhubaneswar over a period of 30 months (April 2019 to October 2021) after getting approval from the Institute’s Research and Ethics committee. It is a Prospective Cohort Study, involving 210 scrub typhus RT PCR positive cases aged more than 18 years.19 cases were excluded because of co infection with other tropical fevers. Cases with CKD, malignancy, tuberculosis and autoimmune diseases were excluded from our study.

Discussion

Results: 191 cases out of 210 cases of scrub typhus (PCR positive) were subjected for study after excluding the co infection. Out of which 95 (45.2%) cases were detected to have AKI. 61 (64.2%) patients were male and 34 (35.8%) were female. Mean duration of hospital stay was 13.6 days. 21 (22.1%) patients underwent hemodialysis. 16 (16.8%) patients had requirement of mechanical ventilation. Average number of sessions of hemodialysis done in patients without requirement of mechanical ventilation was 2.33 times compared to 4.1 times in those requiring mechanical ventilation. All the patients received doxycycline along with other supportive therapy. There was no mortality observed during the study period. 63 cases were followed up for a median of one year, out of which two (3.17%) patients have developed CKD. Conclusion: Incidence of AKI in scrub typhus is high and have good outcome if diagnosed and treated early.