Giuseppe
Emeritus
[Source: PLoS ONE, full text: (LINK). Abstract, edited.]
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Research Article
Thrombocytopenia as a Predictor of Severe Acute Kidney Injury in Patients with Hantaan Virus Infections
Meiliang Wang, Jiuping Wang, Tianping Wang, Jing Li, Ling Hui, Xiaoqin Ha
Affiliations: [See Source Page.]
Abstract
Background
Hematological abnormalities often occur several days before kidney injury in patients with hemorrhagic fever with renal syndrome (HFRS). We aimed to investigate the prevalence and prognostic value of the early hematological markers in patients with HFRS caused by Hantaan virus (HTNV) infection.
Methods
In a retrospective cohort study, we analyzed the case records of 112 patients with acute HTNV infection and evaluated the hematological markers for early prediction and risk stratification of HFRS patients with acute kidney injury (AKI).
Results
Of 112 patients analyzed, 66 (59%) developed severe AKI, defined as either receipt of acute dialysis or increased serum creatinine ≥354 ?mol/L. The prognostic accuracy of hematological markers, as quantified by the area under the receiver-operating-characteristic curve (AUC), was highest with the nadir platelet count (AUC, 0.89; 95% CI, 0.83?0.95), as compared with the admission platelet count (AUC, 0.84; 95% CI, 0.77?0.92), and the admission and peak leukocyte counts. The nadir platelet count correlated moderately with the levels of peak blood urea nitrogen (r = ?0.616) and serum creatinine (r = ?0.589), the length of hospital stay (r = ?0.599), and the number of dialysis sessions that each patient received during hospital stay (r = ?0.625). By multivariate analysis, decreased nadir platelet count remained independently associated with the development of severe AKI (odds ratio, 27.57; 95% CI, 6.96?109.16; P<0.0001).
Conclusions
Thrombocytopenia, rather than leukocytosis, is independently associated with subsequent severe AKI among patients with acute HTNV infection.
Citation: Wang M, Wang J, Wang T, Li J, Hui L, et al. (2013) Thrombocytopenia as a Predictor of Severe Acute Kidney Injury in Patients with Hantaan Virus Infections. PLoS ONE 8(1): e53236. doi:10.1371/journal.pone.0053236
Editor: Qianjun Li, University of Alabama at Birmingham, United States of America
Received: June 12, 2012; Accepted: November 27, 2012; Published: January 2, 2013
Copyright: ? 2013 Wang et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Funding: The authors have no support or funding to report.
Competing interests: The authors have declared that no competing interests exist.
* E-mail: mlwang_2003@yahoo.com
# These authors contributed equally to this work.
-Thrombocytopenia as a Predictor of Severe Acute Kidney Injury in Patients with Hantaan Virus Infections
Meiliang Wang, Jiuping Wang, Tianping Wang, Jing Li, Ling Hui, Xiaoqin Ha
Affiliations: [See Source Page.]
Abstract
Background
Hematological abnormalities often occur several days before kidney injury in patients with hemorrhagic fever with renal syndrome (HFRS). We aimed to investigate the prevalence and prognostic value of the early hematological markers in patients with HFRS caused by Hantaan virus (HTNV) infection.
Methods
In a retrospective cohort study, we analyzed the case records of 112 patients with acute HTNV infection and evaluated the hematological markers for early prediction and risk stratification of HFRS patients with acute kidney injury (AKI).
Results
Of 112 patients analyzed, 66 (59%) developed severe AKI, defined as either receipt of acute dialysis or increased serum creatinine ≥354 ?mol/L. The prognostic accuracy of hematological markers, as quantified by the area under the receiver-operating-characteristic curve (AUC), was highest with the nadir platelet count (AUC, 0.89; 95% CI, 0.83?0.95), as compared with the admission platelet count (AUC, 0.84; 95% CI, 0.77?0.92), and the admission and peak leukocyte counts. The nadir platelet count correlated moderately with the levels of peak blood urea nitrogen (r = ?0.616) and serum creatinine (r = ?0.589), the length of hospital stay (r = ?0.599), and the number of dialysis sessions that each patient received during hospital stay (r = ?0.625). By multivariate analysis, decreased nadir platelet count remained independently associated with the development of severe AKI (odds ratio, 27.57; 95% CI, 6.96?109.16; P<0.0001).
Conclusions
Thrombocytopenia, rather than leukocytosis, is independently associated with subsequent severe AKI among patients with acute HTNV infection.
Citation: Wang M, Wang J, Wang T, Li J, Hui L, et al. (2013) Thrombocytopenia as a Predictor of Severe Acute Kidney Injury in Patients with Hantaan Virus Infections. PLoS ONE 8(1): e53236. doi:10.1371/journal.pone.0053236
Editor: Qianjun Li, University of Alabama at Birmingham, United States of America
Received: June 12, 2012; Accepted: November 27, 2012; Published: January 2, 2013
Copyright: ? 2013 Wang et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Funding: The authors have no support or funding to report.
Competing interests: The authors have declared that no competing interests exist.
* E-mail: mlwang_2003@yahoo.com
# These authors contributed equally to this work.
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