ACUTE TUBULAR NECROSIS AND DENGUE

February 24^th, 2014

Sir,

The recent article on “acute tubular necrosis and dengue” is very interesting². REPIZO et al. concluded that “serum creatine phosphokinase should be monitored in DF patients to allow for an early diagnosis of rhabdomyolysis and the institution of renal protective measures²”. In fact, the renal complication of dengue is not rare and it should be kept in mind for all practitioners⁵. The renal problem in dengue can be seen in either hemorrhagic or non-hemorrhagic cases¹. The underlying etiology of renal failure is believed to be due to the poor fluid management of the infected cases⁴. The strong clinical relationship with fatality can be seen in such cases. The immunopathology seems to have little role in induction of acute tubular necrosis³. The patient with a previous renal problem has a greater risk to develop renal failure. A careful follow-up of the fluid replacement therapy is the key factor for success in control and prevention of acute renal episode in dengue patients.

REFERENCES

• ¹
  Mohsin N, Mohamed E, Gaber M, Obaidani I, Budruddin M, Al Busaidy S. Acute tubular necrosis associated with non-hemorrhagic dengue fever: a case report. Ren Fail. 2009;31:736-9.
• ²
  Repizo LP, Malheiros DM, Yu L, Barros RT, Burdmann EA. Biopsy proven acute tubular necrosis due to rhabdomyolysis in a dengue fever patient: a case report and review of literature. Rev Inst Med Trop São Paulo. 2014;56:85-8.
• ³
  Wiwanitkit V. Immune complex: does it have a role in pathogenesis of renal failure in dengue infection? Ren Fail. 2005;27:803-4.
• ⁴
  Wiwanitkit V. Acute renal failure in the fatal cases of dengue hemorrhagic fever, a summary in Thai death cases. Ren Fail. 2005;27:647.
• ⁵
  Wiwanitkit V. Dengue fever: diagnosis and treatment. Expert Rev Anti Infect Ther. 2010;8:841-5.

Publication Dates

• Publication in this collection
  Jul-Aug 2014