1. Dialysis for acute kidney injury associated with influenza a (H1N1) infection
- Author
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Carlos Blanco, Eduardo Coste, Marcelo Arias, Sandra Mendez, Bruno Lococo, Augusto Vallejos, Ricardo Martínez, Miguel Simon, Luis Sintado, Jorge Cestari, Miguel Raño, and Ana María Cusumano
- Subjects
Adult ,Male ,medicine.medical_specialty ,Time Factors ,Critical Care ,medicine.medical_treatment ,Argentina ,lcsh:Medicine ,Comorbidity ,Kaplan-Meier Estimate ,urologic and male genital diseases ,Time-to-Treatment ,law.invention ,Young Adult ,Influenza A Virus, H1N1 Subtype ,Renal Dialysis ,Risk Factors ,law ,Diabetes mellitus ,Influenza, Human ,medicine ,Humans ,Renal replacement therapy ,Intensive care medicine ,Pandemics ,Dialysis ,Retrospective Studies ,Mechanical ventilation ,Chi-Square Distribution ,business.industry ,Mortality rate ,lcsh:R ,Acute kidney injury ,General Medicine ,Acute Kidney Injury ,Middle Aged ,medicine.disease ,Respiration, Artificial ,Intensive care unit ,Treatment Outcome ,Respiratory failure ,Emergency medicine ,Female ,Respiratory Insufficiency ,business - Abstract
In June 2009, the World Health Organization declared a novel influenza A, S-OIV (H1N1), pandemic. We observed 44 consecutive patients during the "first wave" of the pandemic. 70.5% of them showed co-morbidities (hypertension, obesity, chronic respiratory diseases, chronic renal disease, diabetes, pregnancy). Serious cases were admitted to the intensive care unit (ICU), particularly those with severe acute respiratory failure. Some of them developed acute kidney injury (AKI) and required renal replacement therapy (RRT). The average time between admission to the ICU and initiation of RRT was 3.16 ± 2.6 days. At initiation of RRT, most patients required mechanical ventilation. No relationship was found with creatinine-kinase levels. Seventy-five percent of the cases were observed during a 3-week period and mortality, related to respiratory failure, doubling of alanine amino transferase and use of inotropics was 81.8%. In conclusion, the H1N1-infected patients who developed RRT-requiring AKI, in the context of multi-organ failure, showed a high mortality rate. Thus, it is mandatory that elaborate strategies aimed at anticipating potential renal complications associated to future pandemics are implemented.
- Published
- 2013
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