AKI, ARF Common with Pandemic Flu
Manish M. Sood, MD
ORLANDO, Fla.—Acute kidney injury (AKI), acute renal failure , and the need for dialysis are common complications in critically ill patients with pandemic H1N1 Influenza A (pH1N1), and are associated with an increased risk of death, according to Canadian researchers.
Manish M. Sood, MD, and colleagues at the University of Manitoba in Winnipeg, prospectively studied 50 patients with pH1N1 (47 confirmed, three probable) admitted to one of seven intensive care units (ICUs) in Manitoba. Subjects had a mean age of 35.5 years and 36 (72%) were women. Dr. Sood reported study findings here at the 2010 National Kidney Foundation's Spring Clinical Meetings.
AKI developed in 32 (66.7%) of the 48 patients for whom this complication could be determined (two patients were excluded from analysis because they had chronic kidney disease). Eleven patients (22%) required dialysis; of these, 10 recovered. Eight patients (16%) died.
AKI and kidney failure were associated with a 5.7- and 11-fold increased risk of death, respectively. The need for dialysis was associated with a 21% increased mortality risk. In addition, patients requiring dialysis had a significantly increased ICU stay compared with those not requiring dialysis (mean 33.3 vs. 19.3 days).
“Critically ill patients with pH1N1 infection suffer a high rate of kidney injury, kidney failure, and the need for dialytic therapies,” concluded Dr. Sood, Assistant Professor of Nephrology, and Director of Hemodialysis at St. Boniface General Hospital in Winnipeg. “Kidney injury was strongly associated with mortality.”
He added that the longer ICU stays for patients needing dialysis “could significantly stress hospital resources in the event of a future outbreak.”