The role of glomerular lesions in the prognosis of patients with acute kidney injury during hemorrhagic fever with renal syndrome

AbstractObjective This study aimed to explore the role of glomerular lesions in patients who suffered from acute kidney injury (AKI) during hemorrhagic fever with renal syndrome (HFRS).Methods The study comprised 66 patients with AKI during HFRS treated at the National Clinical Research Center of Ki...

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Main Authors: Min Min, Meiling Liu, Chunyu Lu, Lina Zhu, Jiong Zhang, Jinquan Wang
Format: Article
Language:English
Published: Taylor & Francis Group 2023-12-01
Series:Renal Failure
Subjects:
Online Access:https://www.tandfonline.com/doi/10.1080/0886022X.2023.2196349
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author Min Min
Meiling Liu
Chunyu Lu
Lina Zhu
Jiong Zhang
Jinquan Wang
author_facet Min Min
Meiling Liu
Chunyu Lu
Lina Zhu
Jiong Zhang
Jinquan Wang
author_sort Min Min
collection DOAJ
description AbstractObjective This study aimed to explore the role of glomerular lesions in patients who suffered from acute kidney injury (AKI) during hemorrhagic fever with renal syndrome (HFRS).Methods The study comprised 66 patients with AKI during HFRS treated at the National Clinical Research Center of Kidney Diseases of China, Jinling Hospital, from January 2014 to December 2018. According to the kidney pathological findings, the 66 patients were divided into two groups: the tubulointerstitial injury group (HFRS-TI group, n = 43) and the tubulointerstitial injury with glomerular lesions group (HFRS-GL group, n = 23). The clinical and pathological characteristics of the 66 patients were analyzed.Results There were 9 cases of IgA nephropathy, 1 case of membranous nephropathy, 2 cases of diabetic nephropathy, and 11 cases of mesangial proliferative glomerulonephritis in the HFRS-GL group. There were more males in the HFRS-GL group than in the HFRS-TI group (92.3% vs. 69.8%, p < .05). A higher proportion of interstitial fibrosis (56.5% vs. 27.9%, p < .05) and more immunoglobulin and complement depositions (p < .001) were observed in the HFRS-GL group than in the HFRS-TI group. Rates of remission of AKI were lower in the HFRS-GL group than in the HFRS-TI group (73.9% vs. 95.3%, p < .05). The presence of glomerular lesions (HR = 5.636, 95% CI = 1.121–28.329, p = .036) and moderate tubulointerstitial injury (HR = 3.598, 95% CI = 1.278–10.125, p = .015) were found to be independent risk factors for kidney prognosis.Conclusions Patients with AKI during HFRS can have glomerular lesions or glomerulonephritis. Patients with AKI during HFRS who have glomerular lesions or moderate renal tubulointerstitial injury proven by kidney biopsy have a relatively poor kidney prognosis. A kidney biopsy can help determine long-term prognosis in patients with AKI during HFRS.
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spelling doaj.art-0bb5964faac44328a83e17e3394934722023-10-17T09:23:24ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492023-12-0145110.1080/0886022X.2023.2196349The role of glomerular lesions in the prognosis of patients with acute kidney injury during hemorrhagic fever with renal syndromeMin Min0Meiling Liu1Chunyu Lu2Lina Zhu3Jiong Zhang4Jinquan Wang5National Clinical Research Center of Kidney Diseases, Jingling Hospital, Nanjing Medical University, Nanjing, ChinaDepartment of Nephrology, Anqing First People’s Hospital of Anhui Medical University, Anqing, ChinaNational Clinical Research Center of Kidney Diseases, Jingling Hospital, Nanjing Medical University, Nanjing, ChinaNational Clinical Research Center of Kidney Diseases, Jingling Hospital, Nanjing Medical University, Nanjing, ChinaNational Clinical Research Center of Kidney Diseases, Jingling Hospital, Nanjing Medical University, Nanjing, ChinaNational Clinical Research Center of Kidney Diseases, Jingling Hospital, Nanjing Medical University, Nanjing, ChinaAbstractObjective This study aimed to explore the role of glomerular lesions in patients who suffered from acute kidney injury (AKI) during hemorrhagic fever with renal syndrome (HFRS).Methods The study comprised 66 patients with AKI during HFRS treated at the National Clinical Research Center of Kidney Diseases of China, Jinling Hospital, from January 2014 to December 2018. According to the kidney pathological findings, the 66 patients were divided into two groups: the tubulointerstitial injury group (HFRS-TI group, n = 43) and the tubulointerstitial injury with glomerular lesions group (HFRS-GL group, n = 23). The clinical and pathological characteristics of the 66 patients were analyzed.Results There were 9 cases of IgA nephropathy, 1 case of membranous nephropathy, 2 cases of diabetic nephropathy, and 11 cases of mesangial proliferative glomerulonephritis in the HFRS-GL group. There were more males in the HFRS-GL group than in the HFRS-TI group (92.3% vs. 69.8%, p < .05). A higher proportion of interstitial fibrosis (56.5% vs. 27.9%, p < .05) and more immunoglobulin and complement depositions (p < .001) were observed in the HFRS-GL group than in the HFRS-TI group. Rates of remission of AKI were lower in the HFRS-GL group than in the HFRS-TI group (73.9% vs. 95.3%, p < .05). The presence of glomerular lesions (HR = 5.636, 95% CI = 1.121–28.329, p = .036) and moderate tubulointerstitial injury (HR = 3.598, 95% CI = 1.278–10.125, p = .015) were found to be independent risk factors for kidney prognosis.Conclusions Patients with AKI during HFRS can have glomerular lesions or glomerulonephritis. Patients with AKI during HFRS who have glomerular lesions or moderate renal tubulointerstitial injury proven by kidney biopsy have a relatively poor kidney prognosis. A kidney biopsy can help determine long-term prognosis in patients with AKI during HFRS.https://www.tandfonline.com/doi/10.1080/0886022X.2023.2196349Hemorrhagic fever with renal syndromeacute kidney injuryglomerular lesionHantavirusprognosis
spellingShingle Min Min
Meiling Liu
Chunyu Lu
Lina Zhu
Jiong Zhang
Jinquan Wang
The role of glomerular lesions in the prognosis of patients with acute kidney injury during hemorrhagic fever with renal syndrome
Renal Failure
Hemorrhagic fever with renal syndrome
acute kidney injury
glomerular lesion
Hantavirus
prognosis
title The role of glomerular lesions in the prognosis of patients with acute kidney injury during hemorrhagic fever with renal syndrome
title_full The role of glomerular lesions in the prognosis of patients with acute kidney injury during hemorrhagic fever with renal syndrome
title_fullStr The role of glomerular lesions in the prognosis of patients with acute kidney injury during hemorrhagic fever with renal syndrome
title_full_unstemmed The role of glomerular lesions in the prognosis of patients with acute kidney injury during hemorrhagic fever with renal syndrome
title_short The role of glomerular lesions in the prognosis of patients with acute kidney injury during hemorrhagic fever with renal syndrome
title_sort role of glomerular lesions in the prognosis of patients with acute kidney injury during hemorrhagic fever with renal syndrome
topic Hemorrhagic fever with renal syndrome
acute kidney injury
glomerular lesion
Hantavirus
prognosis
url https://www.tandfonline.com/doi/10.1080/0886022X.2023.2196349
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