Related Experiment Videos
Renal involvement in children with influenza A virus infection
Toru Watanabe1, Hideto Yoshikawa, Yuki Abe
1Department of Pediatrics, Niigata City General Hospital, Niigata, Japan. twata@hosp.niigata.niigata.jp
Insights
Renal involvement in influenza A virus infection is uncommon but serious, often linked to sepsis and organ dysfunction in children. Factors like dehydration and hypotension contribute, not direct viral kidney injury.
Area of Science:
- Pediatric Nephrology
- Infectious Diseases
- Critical Care Medicine
Background:
- Renal involvement is a rare complication of influenza A virus infection.
- Understanding its clinical profile and contributing factors is crucial for pediatric cases.
Purpose of the Study:
- To define clinical characteristics of renal involvement in children with influenza A.
- To identify factors contributing to renal complications during influenza A infection.
Main Methods:
- Retrospective review of 45 hospitalized children with influenza A.
- Analysis of clinical data, laboratory results, PRISM scores, SIRS criteria, and organ dysfunction.
- Assessment for renal involvement, sepsis, MODS, and ARF.
Main Results:
- 24.4% of children experienced renal involvement, all with sepsis and MODS.
- Acute renal failure (ARF) occurred in 5 patients.
- Higher incidence of dehydration, hypotension, DIC, rhabdomyolysis, PRISM scores, SIRS criteria, and mortality in those with renal involvement.
- Influenza A RNA was not detected in renal tissues of ARF patients.
Conclusions:
- Renal involvement in pediatric influenza A is associated with sepsis and MODS.
- Dehydration, hypotension, DIC, and rhabdomyolysis are key contributing factors.
- Direct viral kidney injury is unlikely in influenza A-associated renal complications.
Abstract:
Renal involvement in influenza A virus infection has been rarely reported. To define the clinical characteristics and the factors contributing to the development of renal involvement in influenza A virus infection, we reviewed the clinical characteristics, laboratory data, pediatric risk of mortality (PRISM) score, and the number of systemic inflammatory response syndrome (SIRS) criteria and dysfunctional organs in 45 hospitalized children with influenza A virus infection. Eleven (24.4%) patients had renal involvement. All patients with renal involvement suffered from sepsis and multiple organ dysfunction syndrome (MODS) and 5 developed acute renal failure (ARF). The incidences of dehydration, hypotension, disseminated intravascular coagulation (DIC), and rhabdomyolysis were significantly higher in patients with renal involvement. PRISM scores, the numbers of SIRS criteria and dysfunctional organs, and mortality rate were also higher in patients with renal involvement. Influenza A RNA was absent in the renal tissues of 3 patients with ARF. These results suggested that renal involvement in influenza A virus infection occurred in patients with sepsis and MODS; dehydration, hypotension, DIC, and rhabdomyolysis were factors contributing to its development; direct viral injury to the kidney did not seem to occur in influenza A virus infection.