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Saudi Journal of Kidney Diseases and Transplantation
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ORIGINAL ARTICLE Table of Contents   
Year : 2013  |  Volume : 24  |  Issue : 3  |  Page : 527-533
Dialysis for acute kidney injury associated with influenza a (H1N1) infection


1 Nephrology and Kidney Transplant Unit, Argerich Hospital, Buenos Aires City; Nephrology Unit, Sanatorio Junín, Junín City, Buenos Aires Province, Argentina
2 Nephrology Unit, Abete Hospital, Malvinas Argentinas District, Buenos Aires Province, Argentina
3 Instituto de Nefrología Pergamino, Pergamino City, Buenos Aires Province, Argentina
4 Nephrology Unit, Alende Hospital, Mar del Plata City, Buenos Aires Province, Argentina
5 Nephrology Unit, Oñativia Hospital, Rafael Calzada District, Buenos Aires Province, Argentina
6 Nephrology Unit, Churruca Visca Hospital, Buenos Aires City, Argentina
7 Ministry of Health, Buenos Aires City, Argentina
8 Nephrology and Kidney Transplant Unit, Argerich Hospital, Buenos Aires City, Argentina
9 Nephrology Unit, Durand Hospital, Buenos Aires City, Argentina
10 Nephrology Unit, Fernandez Hospital, Buenos Aires City, Argentina
11 Nephrology Unit, Naval Hospital, Buenos Aires City, Argentina
12 Nephrology Unit, Austral Hospital, Pilar District, Buenos Aires Province; AKI-SOIV Working Group, Critical Care Nephrology Council, Buenos Aires Nephrology Association, Buenos Aires City, Argentina

Correspondence Address:
Augusto Vallejos
Nephrology and Kidney Transplant Unit, Argerich Hospital, Buenos Aires City
Argentina
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DOI: 10.4103/1319-2442.111045

PMID: 23640625

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In June 2009, the World Health Organization declared a novel influenza A, S-OIV (H1N1), pandemic. We observed 44 consecutive patients during the "first wave" of the pandemic. 70.5% of them showed co-morbidities (hypertension, obesity, chronic respiratory diseases, chronic renal disease, diabetes, pregnancy). Serious cases were admitted to the intensive care unit (ICU), particularly those with severe acute respiratory failure. Some of them developed acute kidney injury (AKI) and required renal replacement therapy (RRT). The average time between admission to the ICU and initiation of RRT was 3.16 ± 2.6 days. At initiation of RRT, most patients required mechanical ventilation. No relationship was found with creatinine-kinase levels. Seventy-five percent of the cases were observed during a 3-week period and mortality, related to respiratory failure, doubling of alanine amino transferase and use of inotropics was 81.8%. In conclusion, the H1N1-infected patients who developed RRT-requiring AKI, in the context of multi-organ failure, showed a high mortality rate. Thus, it is mandatory that elaborate strategies aimed at anticipating potential renal complications associated to future pandemics are implemented.


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