Clinical characteristics and outcomes of acute kidney injury in patients with severe fever with thrombocytopenia syndrome
BackgroundSevere fever with thrombocytopenia syndrome (SFTS) is an emerging zoonosis caused by a novel bunyavirus. Until recently, the SFTS related acute kidney injury (AKI) was largely unexplored. This study aimed to investigate the clinical characteristics and outcomes of AKI in patients with SFTS...
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Frontiers Media S.A.
2023-09-01
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| Series: | Frontiers in Microbiology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmicb.2023.1236091/full |
| _version_ | 1797687142697140224 |
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| author | Zhongwei Zhang Xue Hu Qunqun Jiang Wenjia Hu Anling Li Liping Deng Yong Xiong |
| author_facet | Zhongwei Zhang Xue Hu Qunqun Jiang Wenjia Hu Anling Li Liping Deng Yong Xiong |
| author_sort | Zhongwei Zhang |
| collection | DOAJ |
| description | BackgroundSevere fever with thrombocytopenia syndrome (SFTS) is an emerging zoonosis caused by a novel bunyavirus. Until recently, the SFTS related acute kidney injury (AKI) was largely unexplored. This study aimed to investigate the clinical characteristics and outcomes of AKI in patients with SFTS.MethodsThe non-AKI and AKI groups were compared in terms of general characteristics, clinical features, laboratory parameters and cumulative survival rate. The independent risk factors for in-hospital mortality in patients with SFTS were analyzed by multivariate logistic regression to identify the population with poor prognosis.ResultsA total of 208 consecutive patients diagnosed with SFTS were enrolled, including 153 (73.6%) patients in the non-AKI group and 55 (26.4%) patients in the AKI group. Compared with patients without AKI, patients with AKI were older and had a higher frequency of diabetes. Among these laboratory parameters, platelet count, albumin and fibrinogen levels of patients with AKI were identified to be significantly lower than those of patients without AKI, while ALT, AST, ALP, triglyceride, LDH, BUN, uric acid, creatine, Cys-C, β2-MG, potassium, AMY, lipase, CK-MB, TnI, BNP, APTT, thrombin time, D-dimer, CRP, IL-6, PCT and ESR levels were significantly higher in patients with AKI. A higher SFTS viral load was also detected in the AKI patients than in the non-AKI patients. The cumulative survival rates of patients at AKI stage 2 or 3 were significantly lower than those of patients without AKI or at AKI stage 1. However, there was no significant difference in the cumulative survival rates between patients without AKI and those with stage 1 AKI. Univariate and multivariate binary logistic regression analyses demonstrated that stage 2 or 3 AKI was an independent risk factor for in-hospital mortality in patients with SFTS.ConclusionAKI is associated with poor outcomes in patients with SFTS, especially patients at AKI stage 2 or 3, who generally have high mortality. Our findings support the importance of early identification and timely treatment of AKI in patients with SFTS. |
| first_indexed | 2024-03-12T01:15:02Z |
| format | Article |
| id | doaj.art-c1b6c4dbe95b49c587eec578eb8fb260 |
| institution | Directory Open Access Journal |
| issn | 1664-302X |
| language | English |
| last_indexed | 2024-03-12T01:15:02Z |
| publishDate | 2023-09-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Microbiology |
| spelling | doaj.art-c1b6c4dbe95b49c587eec578eb8fb2602023-09-13T19:43:30ZengFrontiers Media S.A.Frontiers in Microbiology1664-302X2023-09-011410.3389/fmicb.2023.12360911236091Clinical characteristics and outcomes of acute kidney injury in patients with severe fever with thrombocytopenia syndromeZhongwei Zhang0Xue Hu1Qunqun Jiang2Wenjia Hu3Anling Li4Liping Deng5Yong Xiong6Department of Infectious Disease, Zhongnan Hospital of Wuhan University, Wuhan, ChinaDepartment and Institute of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDepartment of Infectious Disease, Zhongnan Hospital of Wuhan University, Wuhan, ChinaDepartment of Infectious Disease, Zhongnan Hospital of Wuhan University, Wuhan, ChinaDepartment of Clinical Laboratory, Center for Gene Diagnosis, and Program of Clinical Laboratory Medicine, Zhongnan Hospital of Wuhan University, Wuhan, ChinaDepartment of Infectious Disease, Zhongnan Hospital of Wuhan University, Wuhan, ChinaDepartment of Infectious Disease, Zhongnan Hospital of Wuhan University, Wuhan, ChinaBackgroundSevere fever with thrombocytopenia syndrome (SFTS) is an emerging zoonosis caused by a novel bunyavirus. Until recently, the SFTS related acute kidney injury (AKI) was largely unexplored. This study aimed to investigate the clinical characteristics and outcomes of AKI in patients with SFTS.MethodsThe non-AKI and AKI groups were compared in terms of general characteristics, clinical features, laboratory parameters and cumulative survival rate. The independent risk factors for in-hospital mortality in patients with SFTS were analyzed by multivariate logistic regression to identify the population with poor prognosis.ResultsA total of 208 consecutive patients diagnosed with SFTS were enrolled, including 153 (73.6%) patients in the non-AKI group and 55 (26.4%) patients in the AKI group. Compared with patients without AKI, patients with AKI were older and had a higher frequency of diabetes. Among these laboratory parameters, platelet count, albumin and fibrinogen levels of patients with AKI were identified to be significantly lower than those of patients without AKI, while ALT, AST, ALP, triglyceride, LDH, BUN, uric acid, creatine, Cys-C, β2-MG, potassium, AMY, lipase, CK-MB, TnI, BNP, APTT, thrombin time, D-dimer, CRP, IL-6, PCT and ESR levels were significantly higher in patients with AKI. A higher SFTS viral load was also detected in the AKI patients than in the non-AKI patients. The cumulative survival rates of patients at AKI stage 2 or 3 were significantly lower than those of patients without AKI or at AKI stage 1. However, there was no significant difference in the cumulative survival rates between patients without AKI and those with stage 1 AKI. Univariate and multivariate binary logistic regression analyses demonstrated that stage 2 or 3 AKI was an independent risk factor for in-hospital mortality in patients with SFTS.ConclusionAKI is associated with poor outcomes in patients with SFTS, especially patients at AKI stage 2 or 3, who generally have high mortality. Our findings support the importance of early identification and timely treatment of AKI in patients with SFTS.https://www.frontiersin.org/articles/10.3389/fmicb.2023.1236091/fullsevere fever with thrombocytopenia syndromeacute kidney injuryclinical characteristicsrisk factormortality |
| spellingShingle | Zhongwei Zhang Xue Hu Qunqun Jiang Wenjia Hu Anling Li Liping Deng Yong Xiong Clinical characteristics and outcomes of acute kidney injury in patients with severe fever with thrombocytopenia syndrome Frontiers in Microbiology severe fever with thrombocytopenia syndrome acute kidney injury clinical characteristics risk factor mortality |
| title | Clinical characteristics and outcomes of acute kidney injury in patients with severe fever with thrombocytopenia syndrome |
| title_full | Clinical characteristics and outcomes of acute kidney injury in patients with severe fever with thrombocytopenia syndrome |
| title_fullStr | Clinical characteristics and outcomes of acute kidney injury in patients with severe fever with thrombocytopenia syndrome |
| title_full_unstemmed | Clinical characteristics and outcomes of acute kidney injury in patients with severe fever with thrombocytopenia syndrome |
| title_short | Clinical characteristics and outcomes of acute kidney injury in patients with severe fever with thrombocytopenia syndrome |
| title_sort | clinical characteristics and outcomes of acute kidney injury in patients with severe fever with thrombocytopenia syndrome |
| topic | severe fever with thrombocytopenia syndrome acute kidney injury clinical characteristics risk factor mortality |
| url | https://www.frontiersin.org/articles/10.3389/fmicb.2023.1236091/full |
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