Kidney Week

Abstract: SA-PO0315

AKI in Dengue and Chikungunya: Comparative Outcomes in Polymerase Chain Reaction (PCR)-Confirmed Cases

Session Information

• AKI: Epidemiology and Risk Factors
  October 24, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Acute Kidney Injury

• 101 AKI: Epidemiology, Risk Factors, and Prevention

Authors

• Inacio, Larissa dos Santos, Faculdade de Medicina de Sao Jose do Rio Preto, Sao Jose do Rio Preto, SP, Brazil

Larissa dos Santos Inacio, MD

• Francischini, Bruna, Faculdade de Medicina de Sao Jose do Rio Preto, Sao Jose do Rio Preto, SP, Brazil

Bruna Francischini, MD

• Passarín, Luís Eugênio, Faculdade de Medicina de Sao Jose do Rio Preto, Sao Jose do Rio Preto, SP, Brazil

Luís Eugênio Passarín, DrMed

• Dos Santos, Karise Fernandes, Faculdade de Medicina de Sao Jose do Rio Preto, Sao Jose do Rio Preto, SP, Brazil

Karise Fernandes Dos Santos

• Brancini, Marini Lino, Faculdade de Medicina de Sao Jose do Rio Preto, Sao Jose do Rio Preto, SP, Brazil

Marini Lino Brancini, MSc

• Estofolete, Cassia F., Faculdade de Medicina de Sao Jose do Rio Preto, Sao Jose do Rio Preto, SP, Brazil

Cassia F. Estofolete, PhD

• Tome, Ana Carolina Nakamura, Faculdade de Medicina de Sao Jose do Rio Preto, Sao Jose do Rio Preto, SP, Brazil

Ana Carolina Nakamura Tome, MD, MS, MSc

• Lima, Emerson Quintino, Faculdade de Medicina de Sao Jose do Rio Preto, Sao Jose do Rio Preto, SP, Brazil

Emerson Quintino Lima, MD, PhD

• Nogueira, Mauricio Lacerda, Faculdade de Medicina de Sao Jose do Rio Preto, Sao Jose do Rio Preto, SP, Brazil

Mauricio Lacerda Nogueira, MD, PhD

• Ramalho, Rodrigo J., Faculdade de Medicina de Sao Jose do Rio Preto, Sao Jose do Rio Preto, SP, Brazil

Rodrigo J. Ramalho, MD, PhD

Background

Dengue (DEN) and chikungunya (CHIK) are arboviral infections with active transmission in multiple countries, including Brazil. Acute kidney injury (AKI) is associated with increased morbidity and mortality. This study aimed to compare AKI incidence and clinical outcomes in adult patients with DEN and CHIK.

Methods

Single-center retrospective study based on electronic medical records of adults (>18 years) with PCR-confirmed DEN or CHIK admitted to a university hospital between January 2024 and 2025. Patients with prior kidney transplantation or on dialysis due to chronic kidney disease were excluded. AKI was defined according to KDIGO criteria.

Results

During the study period, 830 patients were identified, and 619 were included (DEN=467; CHIK=152). Male sex predominated, with no significant differences in baseline creatinine, electrolytes, or admission urinalysis findings. CHIK was older (53±19 vs. 47±17, p=0.001) and presented more hypertension (40,1% vs. 20,1%, p<0,0001), diabetes mellitus (16,4% vs. 10%, p=0,03), and chronic kidney disease (10% vs. 3,4%, p=0,01). DEN showed higher hemoglobin levels, lower leukocyte and platelet counts, and higher AST levels. Initial creatinine levels were higher in CHIK (1,4±1,3 vs. 1,1±0,7 mg/dL, p=NS), which was also associated with a higher incidence of AKI (31% vs. 18,2%, p=0,01) and renal replacement therapy (RRT) (2,4% vs. 0,4%, p=0,04). CHIK also demonstrated higher rates of hospitalization (45,3% vs. 30,2%, p<0,001), intensive care unit (ICU) admission (7,8% vs. 3,8%, p=0,04), vasopressor use (6,5% vs. 2,3%, p=0,01), mechanical ventilation (5.2% vs. 1.2%, p=0.004), and mortality (4.6% vs. 1.7%, p=0.06). Independent risk factors for AKI in both arboviral infections were diabetes mellitus (OR: 3,6 [95% CI: 1,3–9,8]; p=0,009), ICU admission (OR: 14,8 [95% CI: 4,06–61,4]; p<0,0001), and higher admission creatinine levels (OR: 237,7 [95% CI: 41,4–1868]; p<0,0001). However, chikungunya itself was not independently associated with AKI development.

Conclusion

Although CHIK was associated with worse renal and clinical outcomes, AKI development was more strongly associated with disease severity and baseline comorbidities than with the viral infection itself.