Glucosuria Predicts the Severity of Puumala Hantavirus Infection

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http://hdl.handle.net/10138/305770

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Tietavainen , J , Mantula , P , Outinen , T , Huhtala , H , Porsti , I H , Niemela , O , Vaheri , A , Makela , S & Mustonen , J 2019 , ' Glucosuria Predicts the Severity of Puumala Hantavirus Infection ' , Kidney International Reports , vol. 4 , no. 9 , pp. 1296-1303 . https://doi.org/10.1016/j.ekir.2019.05.770

Title: Glucosuria Predicts the Severity of Puumala Hantavirus Infection
Author: Tietavainen, Johanna; Mantula, Paula; Outinen, Tuula; Huhtala, Heini; Porsti, Ilkka H.; Niemela, Onni; Vaheri, Antti; Makela, Satu; Mustonen, Jukka
Contributor: University of Helsinki, Medicum
Date: 2019-09
Language: eng
Number of pages: 8
Belongs to series: Kidney International Reports
ISSN: 2468-0249
URI: http://hdl.handle.net/10138/305770
Abstract: Introduction: Puumala hantavirus (PUUV) causes a mild type of hemorrhagic fever with renal syndrome characterized by acute kidney injury (AKI), increased capillary leakage, and thrombocytopenia. Albuminuria and hematuria in dipstick urine test at hospital admission are known to predict the severity of upcoming AKI. Methods: We analyzed dipstick urine glucose in 195 patients with acute PUUV infection at hospital admission, and divided them into 2 categories according to the presence or absence of glucose in the dipstick urine test. Determinants of disease severity were analyzed in glucosuric and nonglucosuric patients. Results: Altogether, 24 of 195 patients (12%) had glucosuria. The patients with glucosuria had more severe AKI than patients without glucosuria (median maximum creatinine concentration 459 mmol/l, range 78-1041 mmol/l vs. 166 mmol/l, range 51-1499 mmol/l; P <0.001). The glucosuric patients had more severe thrombocytopenia (median minimum platelet count 41 x 10(9)/l, range 5-102 x 10(9)/l vs. 62 x 10(9)/l, range 3249 x 10(9)/l; P = 0.006), and more pronounced signs of increased capillary leakage (change in weight, maximum plasma hematocrit, minimum plasma albumin). The glucosuric patients were more often in clinical shock at admission (20.8% vs. 1.2%; P <0.001) and the length of hospital stay was longer (median 7.5 days, range 4-22 days vs. 6 days, range 2-30 days; P = 0.009). Conclusion: Glucosuria is relatively rare, but when present it predicts a more severe disease course in patients with acute PUUV infection.
Subject: acute kidney injury
glucosuria
hantavirus
Puumala virus
thrombocytopenia
ACUTE KIDNEY INJURY
NEPHROPATHIA-EPIDEMICA
DISEASE
THROMBOCYTOPENIA
NEPHRITIS
ASSOCIATE
CHILDREN
3121 General medicine, internal medicine and other clinical medicine
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