FREQUENCY OF ACUTE KIDNEY INJURY ASSOCIATED WITH DENGUE FEVER IN A TOGOLESE REFERRAL CENTER

 

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https://storage.unitedwebnetwork.com/files/1099/afed2958c29cb371873b451e26d38d60.pdf
FREQUENCY OF ACUTE KIDNEY INJURY ASSOCIATED WITH DENGUE FEVER IN A TOGOLESE REFERRAL CENTER

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Eyram Makafui Yoan Yawo
AMEKOUDI
Eyram Makafui Yoan Yawo AMEKOUDI eyramyoan@gmail.com Centre Hospitalier Universitaire de Kara, Université de Kara Nephrology and hemodialysis departement Kara Togo *
Badomta DOLAAMA badomta@gmail.com Centre Hospitalier Universitaire- Sylvanus Olympio, Université de Lomé Nephrology and hemodialysis departement Lomé Togo -
Laune Odilon BLATOME launeblatome@gmail.com Centre Hospitalier Universitaire de Kara, Université de Kara Nephrology and hemodialysis departement Kara Togo -
Tamantche YANGBA tamantche@gmail.com Centre Hospitalier Universitaire- Sylvanus Olympio, Université de Lomé Nephrology and hemodialysis departement Lomé Togo -
Kossi Akomola SABI kossi.sabi@gmail.com Centre Hospitalier Universitaire- Sylvanus Olympio, Université de Lomé Nephrology and hemodialysis departement Lomé Togo -
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Acute Kidney Injury (AKI) is a frequent complication of dengue fever. Data describing its clinical presentation are limited in Togo, an endemic area. Early identification of patients at risk is crucial to reduce morbidity and mortality. This study aimed to describe the epidemiological and clinical profile of dengue-associated AKI in a Togolese tertiary referral center.

It was a descriptive, observational case series conducted on fifty-eight (58) patients who developed AKI secondary to dengue virus infection proved by PCR. All cases were admitted to the Department of Nephrology and Hemodialysis at the Sylvanus Olympio University Hospital between January and December 2024. AKI was defined and staged according to the KDIGO 2012 criteria. Epidemiological, clinical, laboratory, therapeutic, and outcome data were collected and analyzed.

The incidence of AKI among dengue fever patients was 19.08%. The mean age was 48 ± 21 years (range: 20–94 years), with a male predominance (sex ratio = 3.83). The main presenting symptoms were fever (96.55%), asthenia (68.97%), and myalgia (58.62%). Oliguria or anuria was observed in 76% of cases. Among comorbidities, hypertension (27.59%) and diabetes mellitus (13.79%) were the most common. Classic dengue accounted for 66% of cases, whereas severe dengue represented 34%. Regarding AKI severity, 55.17% of patients were classified as KDIGO stage 3 and 6.9% as stage 2. The predominant mechanism of AKI was hypovolemia (84.48%).
Biochemically, all patients had elevated serum creatinine levels, with a mean value of 69.8 ± 36.4 mg/L. Anemia was found in 51.72% of cases, hyponatremia in 58.62%, and hyperkalemia in 13.79%. Hepatitis B virus infection and malaria co-infection were present in 10% and 20.69% of cases, respectively. Management primarily included rehydration therapy (100%) and antipyretics (68.97%). Hemodialysis was required in 31.03% of patients. Renal recovery was complete in 75.86% of cases, while mortality reached 24%.

Dengue-associated acute kidney injury appears to be a frequent and severe complication in our practice, occurring mainly in patients with significant comorbidities and likely driven by hypovolemia. Although renal recovery is often achievable, mortality remains high. Prospective studies are warranted to identify predictors of poor outcomes and to evaluate long-term renal sequelae

Kewords