Características clínicas y factores de riesgo de la lesión renal aguda en pacientes hospitalizados con dengue en el Hospital Infantil Napoleón Franco Pareja de Cartagena- Colombia

Maria Elena Buendia-De Avila, Emil Julio-Barrios

Resumen


Introducción: la lesión renal aguda (LRA) es una complicación frecuente de la infección por el virus del dengue que ha sido poco estudiada, especialmente en pacientes pediátricos. Se ha descrito que está asociada a mayor mortalidad y estancia hospitalaria, sin embargo, los estudios que evalúan su incidencia, factores de riesgo y desenlaces son escasos.

Objetivos: determinar las características, los factores de riesgo y los desenlaces de los pacientes pediátricos con LRA hospitalizados por dengue con signos de alarma o dengue grave.

Materiales y métodos: se realizó un estudio observacional de cohorte prospectivo en el cual se analizaron y compararon las características clínicas de los pacientes hospitalizados por dengue grave o con signos de alarma en un hospital infantil del Caribe colombiano. Se evaluaron potenciales factores de riesgo asociados a LRA.

Resultados: se recopiló información de 122 pacientes, de los cuales 16.3% presentaron insuficiencia renal aguda. El análisis comparativo mostró que los pacientes con LRA presentaron con mayor frecuencia resequedad de mucosas, aspecto anormal de la piel, presencia de derrame pleural o ascitis. Los niveles séricos de nitrógeno ureico, transaminasa glutámica, transaminasa pirúvica, así como el recuento leucocitario total, tiempo de protrombina y de tromboplastina también fueron mayores. El análisis de regresión logística univariante y multivariante permitió confirmar la oliguria como el único factor de riesgo independiente para el desarrollo de insuficiencia renal aguda, y tendencia a la asociación con la presencia de ascitis o derrame pleural.

Conclusión: en el presente estudio la incidencia de LRA fue alta, en comparación con estudios previos. Se asoció con mayor estancia hospitalaria y necesidad de manejo en cuidados intensivos. El único factor de riesgo identificable fue la oliguria. Rev.cienc. biomed. 2016;7(2):223-233.

 

PALABRAS CLAVE

Dengue; Falla renal aguda; Lesión renal aguda; Pediatría; Virus del dengue.

 

SUMMARY

Introduction: acute kidney injury is a frequent but poorly studied complication of dengue virus infection, mainly, in pediatric population. It has been associated with longer hospital stay and mortality, however, the studies that assessment its incidence, risk factors and clinical outcomes are scarce.

Objective: to assess clinical characteristics, risk factors, and clinical outcomes in pediatric inpatients with dengue virus-associated with acute kidney injury.

Material and methods: a prospective observational cohort study was carried out to assess and compare the clinical characteristics in inpatients with severe and hemorrhagic dengue virus infection from a Colombian pediatric hospital, as well, to check the risk factors for dengue virus-associated with acute kidney injury.

Results: data from 122 patients were obtained; 16.3% of them presented acute kidney injury. Comparative analysis showed that patients with acute kidney injury, dry mucosae, abnormal skin aspect, pleural effusion or ascites, serum levels of ureic nitrogen, glutamic transaminase, pyruvic transaminase, as well as total leucocyte count, prothrombin time and thromboplastin time were higher in patients with acute kidney injury. Univariant and multivariant logistic regression models showed that oliguria was the unique risk factor associated with dengue virus-associated acute kidney injury, and there was a trend to association with pleural effusion or ascites.

Conclusion: the incidence of dengue virus-associated with acute kidney injury was high, compared with previous studies. It was related to a longer hospital stay and need for intensive care. In the present study, oliguria was the unique independent risk factor for dengue virus-associated with acute kidney injury. Rev.cienc.biomed. 2016;7(2):223-233.

KEYWORDS

Acute kidney injury; Acute kidney failure; Dengue fever; Pediatrics; Dengue virus.


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