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Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
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Chronic Kidney Disease (CKD) progressively impairs multiple body systems due to the accumulation of uremic toxins, which disrupt cellular functions across various organs.Neurologic symptomsNeurologic symptoms often arise early in CKD, as uremic toxin buildup drives changes in cognitive and motor functions. Patients frequently experience fatigue, headache, confusion, difficulty concentrating, and, in severe cases, seizures. Peripheral neuropathy commonly manifests as burning sensations in the...
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Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
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Acute kidney injury (AKI) causes are categorized into three primary categories based on the location of the injury: prerenal, intrarenal (or intrinsic), and postrenal causes. This classification guides clinical management and illustrates how different pathways can impair kidney function.Etiology and Pathophysiology of Acute Kidney Injury1. Prerenal causesEtiology: Prerenal Acute Kidney Injury, the most common type, occurs when reduced blood flow to the kidneys decreases filtration capacity...
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Pyelonephritis is a bacterial infection that primarily affects the renal parenchyma and collecting system, including the renal pelvis, tubules, and interstitial tissue of one or both kidneys. It can be classified as either acute—a sudden, severe infection—or chronic, which refers to long-term or recurrent kidney infections.The primary cause of acute pyelonephritis (APN) is bacterial infection, with Escherichia coli accounting for approximately 70-80% of cases. Other bacteria, such...
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Chikungunya virus as a trigger for different renal disorders: an exploratory study.

Denise Maria do Nascimento Costa1, Carlos Eduardo Machado2, Precil Diego Neves3

  • 1Nephrology Department, Hospital das Clínicas of the Federal University of Pernambuco, Recife, Pernambuco, Brazil. denisecosta_81@yahoo.com.

Journal of Nephrology
|February 4, 2022
PubMed
Summary

Chikungunya virus infection can cause kidney injury, but the virus is not found in kidney tissue. Chikungunya fever may trigger kidney lesions, though viral replication in the kidneys appears unlikely.

Keywords:
Chikungunya feverChikungunya virusGlomerulopathyKidney injury

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Area of Science:

  • Virology
  • Nephrology
  • Pathology

Background:

  • Chikungunya virus (CHIKV) has been detected in renal tissue during acute chikungunya fever.
  • CHIKV-related kidney injury is poorly characterized, and the kidney's role as a viral reservoir remains unclear.
  • Understanding CHIKV's impact on renal health is crucial for patient management.

Purpose of the Study:

  • To investigate histopathological changes in renal tissue following chikungunya fever.
  • To detect viral antigens in renal tissue to assess viral presence.
  • To evaluate kidney injury markers in patients during different phases of chikungunya fever.

Main Methods:

  • An exploratory study involving two groups: patients with biopsy-proven kidney injury post-chikungunya fever and patients with chronic joint manifestations post-chikungunya fever without known kidney injury.
  • Histopathological examination and viral antigen detection in renal biopsies from the first group.
  • Assessment of kidney injury markers (creatinine, proteinuria, hematuria) in the second group.

Main Results:

  • Fifteen patients with kidney injury 0.5-24 months post-chikungunya fever showed predominantly glomerular lesions; no viral antigens were detected in renal tissue.
  • High-risk genotypes were associated with atypical hemolytic uremic syndrome and focal and segmental glomerulosclerosis in affected patients.
  • In 114 patients with chronic joint manifestations, mean creatinine and proteinuria were within normal limits, with one case of isolated hematuria; no renal biopsies were indicated.

Conclusions:

  • Histopathological renal changes occur after chikungunya fever, independent of detectable viral presence in kidney tissue.
  • CHIKV may initiate kidney lesions of varying severity at different stages of infection.
  • Viral replication within renal tissue following chikungunya fever appears improbable.