Patterns of Acute Kidney Injury (AKI) in Dengue Patients: Insights from Tertiary Care Hospitals in Bangladesh

Abstract

Background: Acute kidney damage (AKI) in dengue patients can cause harm and death. AKI patterns, incidence, and risk factors in dengue patients hospitalized to Bangladeshi tertiary care institutions were examined in this study. Methods: A cross-sectional study of 200 adult dengue fever patients at Sylhet MAG Osmani Medical College Hospital was done from January 2024 to July 2024. Demographic, clinical, and laboratory data were gathered, and KDIGO criteria were used to evaluate AKI. Statistics were used to identify risk variables and assess in-hospital patient outcomes. Results: The study cohort comprised 200 dengue patients, predominantly males (65%), with the highest proportion aged 31-50 years (45%). Fever was universal (100%), while vomiting (80%), abdominal pain (70%), and skin rashes (35%) were also prevalent. AKI was observed in 75% of patients, with 45% classified as Stage 1, 35% as Stage 2, and 20% as Stage 3. Reduced urine output was present in 55% of patients, and thrombocytopenia (<100,000/µL) was observed in 90% of cases. Significant risk factors for AKI included age >50 years (OR = 2.45, p = 0.005), male gender (OR = 1.75, p = 0.03), severe dengue (OR = 3.90, p < 0.001), and elevated creatinine levels (>1.5 mg/dL; OR = 5.50, p < 0.001). Serum creatinine demonstrated excellent diagnostic performance (AUC = 0.88), while platelet count (<100,000/µL) also showed predictive value (AUC = 0.72) for AKI. Most patients (85%) achieved full recovery, while 10% experienced persistent renal dysfunction, and 5% succumbed to the condition. Conclusion: AKI is common among dengue patients, with age, sex, and severe symptoms as major risk factors. Early monitoring of creatinine and platelets is crucial for timely intervention and reducing long-term complications.