Hepatic Impairment Induced by Scrub Typhus is Associated with New Onset of Renal Dysfunction

被引:5
|
作者
Liang, Xu-Jing [1 ]
Huang, Si-Min [1 ]
Li, Jian-Ping [2 ]
Zhu, Xian-Nv [3 ]
Lu, Yong-Ping [1 ]
Hocher, Berthold [1 ,4 ]
Chen, You-Peng [1 ]
机构
[1] Jinan Univ, Dept Infect Dis, Affiliated Hosp 1, Guangzhou 510630, Guangdong, Peoples R China
[2] Eighth Peoples Hosp Guangzhou, Dept Infect Dis, Guangzhou 510060, Guangdong, Peoples R China
[3] Second Peoples Hosp Yuebei, Dept Infect Dis, Shaoglian 512028, Peoples R China
[4] Univ Potsdam, Inst Nutr Sci, D-14458 Nuthetal Potsdam, Germany
关键词
hepatic impairment; renal dysfunction; complication; outcome; scrub typhus; CRITICALLY-ILL PATIENTS; TSUTSUGAMUSHI-DISEASE; COMPLICATIONS; INJURY; SOUTH; RISK;
D O I
10.7754/Clin.Lab.2013.121203
中图分类号
R446 [实验室诊断]; R-33 [实验医学、医学实验];
学科分类号
1001 ;
摘要
Background: Scrub typhus is a potentially fatal infectious disease caused by Orientia tsutsugamushi. There is little attention given to hepatic impairment in the adults with scrub typhus. This study investigated the incidence and the prognostic implications of hepatic impairment in patients with scrub typhus. Methods: We retrospectively reviewed a total of 143 adult patients with scrub typhus who were admitted between January 1999 and December 2010 in Guangdong province, China. The patients were divided into three groups, e.g., normal, mild, and moderate to severe groups based on the elevated serum ALT and/or total bilirubin levels. Furthermore, clinical characteristics and prognosis of the patient groups were compared. Results: 109 patients (76.2%) had abnormal liver function. Among the patients with hepatic impairment 45 cases (31.4%), 54 cases (37.8%), and 10 cases (7.0%) had mild, moderate, and severe hepatic damage, respectively. The moderate to severe hepatic impairment group had higher levels of serum creatinine compared with that of normal hepatic function. The incidence of new onset of renal dysfunction - defined as peak serum creatinine >= 176 mu mol/L during hospital stay with no evidence of renal disease prior hospitalization - was 0% in the mild hepatic impairment group, 8.9% in the moderate hepatic impairment group, and 21.9% in the severe hepatic impairment group, (p = 0.005 for trend). Additionally, the patients with hepatic impairment (n = 109) had higher incidences of episodes of thrombocytopenia (45.9% vs. 8.82%, p < 0.001), hypoalbuminemia (50.5% vs. 11.8%, p < 0.001), new onset of renal dysfunction (16.5% vs. 0.0%, p = 0.011), and electrocardiogram abnormality (28.4% vs. 8.82%, p = 0.019) than the patients without hepatic impairment. Conclusions: The degree of hepatic impairment induced by scrub typhus is associated with new onset of renal dysfunction.
引用
收藏
页码:63 / 68
页数:6
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