Monsoon season brings a heightened risk of dengue fever, which can lead to acute kidney injury (AKI), a significant yet often underrecognized complication. While most dengue infections resolve with proper care, severe cases can compromise vital organs, including the kidneys, potentially causing anything from a temporary dip in renal function to debilitating renal failure requiring intensive monitoring or even dialysis. Individuals experiencing severe dengue, marked by complications like bleeding, shock, and profound dehydration, face a higher risk of developing AKI, as do those with pre-existing conditions such as diabetes and hypertension. The subtle onset of AKI can make early detection challenging, as symptoms like reduced urine production, swelling, extreme fatigue, and confusion may not be immediately attributed to kidney issues. Therefore, vigilant monitoring of symptoms and prompt medical evaluation are paramount, especially when fever subsides, as critical complications can still arise. Diagnosis involves urine output analysis and blood tests like serum creatinine and blood urea, while management focuses on balanced fluid administration and supportive care, with dialysis reserved for select severe cases. The most effective prevention strategy lies in early recognition of warning signs and proactive medical attention to minimize the chances of severe kidney complications.

Monsoon season brings a heightened risk of dengue fever, which can lead to acute kidney injury (AKI), a significant yet often underrecognized complication. While most dengue infections resolve with proper care, severe cases can compromise vital organs, including the kidneys, potentially causing anything from a temporary dip in renal function to debilitating renal failure requiring intensive monitoring or even dialysis. Individuals experiencing severe dengue, marked by complications like bleeding, shock, and profound dehydration, face a higher risk of developing AKI, as do those with pre-existing conditions such as diabetes and hypertension. The subtle onset of AKI can make early detection challenging, as symptoms like reduced urine production, swelling, extreme fatigue, and confusion may not be immediately attributed to kidney issues. Therefore, vigilant monitoring of symptoms and prompt medical evaluation are paramount, especially when fever subsides, as critical complications can still arise. Diagnosis involves urine output analysis and blood tests like serum creatinine and blood urea, while management focuses on balanced fluid administration and supportive care, with dialysis reserved for select severe cases. The most effective prevention strategy lies in early recognition of warning signs and proactive medical attention to minimize the chances of severe kidney complications.

Monsoon season brings a heightened risk of dengue fever, which can lead to acute kidney injury (AKI), a significant yet often underrecognized complication. While most dengue infections resolve with proper care, severe cases can compromise vital organs, including the kidneys, potentially causing anything from a temporary dip in renal function to debilitating renal failure requiring intensive monitoring or even dialysis. Individuals experiencing severe dengue, marked by complications like bleeding, shock, and profound dehydration, face a higher risk of developing AKI, as do those with pre-existing conditions such as diabetes and hypertension. The subtle onset of AKI can make early detection challenging, as symptoms like reduced urine production, swelling, extreme fatigue, and confusion may not be immediately attributed to kidney issues. Therefore, vigilant monitoring of symptoms and prompt medical evaluation are paramount, especially when fever subsides, as critical complications can still arise. Diagnosis involves urine output analysis and blood tests like serum creatinine and blood urea, while management focuses on balanced fluid administration and supportive care, with dialysis reserved for select severe cases. The most effective prevention strategy lies in early recognition of warning signs and proactive medical attention to minimize the chances of severe kidney complications.

Monsoon season sees dengue emerge as one of the leading diseases carried by mosquitoes. The majority of individuals who are affected recover through proper treatment and management of the disease condition. Nonetheless, dengue can be severe in some individuals and affect vital organs such as the kidneys. Dengue-related acute kidney injury (AKI) is a key issue, though it is often overlooked. It can vary from a temporary decline in renal function to severely debilitating renal failure necessitating constant monitoring or, in exceptional cases, dialysis. The risk factor is generally higher in patients suffering from severe cases of dengue, often resulting in complications such as bleeding, shock, and severe dehydration.

How can dengue affect the kidneys?

Kidney injury in dengue can be due to various factors. Severe dehydration from fever, vomiting, and reduced fluid intake can decrease blood flow to the kidneys. In severe cases of dengue, plasma leakage can decrease effective circulating blood volume and cause hypotension, leading to inadequate blood supply to the kidneys. Inflammation due to dengue infection may also lead to renal damage. Moreover, complications like muscular injury, bleeding, shock, and electrolyte imbalances can put more pressure on the kidneys.

Who is at greater risk?

It is not true that every person suffering from dengue is going to develop any sort of kidney damage. However, the risk is higher for those who are suffering from serious dengue, shock, or severe bleeding. People with pre-existing impairment, diabetes, hypertension and other chronic conditions can also be monitored very carefully.

What are the warning signs?

The problem with acute kidney injury is that it can sometimes manifest with very few symptoms. As a result, a patient may not realise that his kidney function is declining until the damage becomes more serious, which makes it more difficult to treat the condition. The symptoms of acute kidney injury include lack of urine production, dark urine, swelling around the eyes, tiredness, feeling sick and vomiting, difficulty in breathing, confusion, and high blood pressure. It is important to point out that many of these symptoms may occur when a patient has dengue. This is why medical evaluation and laboratory examination are crucial when the patient’s condition is worsening. Another important thing to bear in mind is that just because the fever starts to go down, it doesn’t mean that the patient is recovering from his illness. In fact, critical moments in dengue are known to take place when the fever begins to decline. Therefore, patients should continue looking for any warnings even when their temperature becomes normal.

How is kidney injury diagnosed?

To evaluate the functioning of the kidneys, doctors can analyse urine production and conduct blood tests called serum creatinine and blood urea tests, which help to determine changes in the kidney filtering process, and electrolytes are studied to identify disruptions in sodium and potassium levels. The doctors might check the blood counts as well as the liver function based on the patient’s condition level and other factors.

How is it managed?

The treatment strategy will depend on the severity of dengue, hydration level, blood pressure, kidney function, and other complications. Fluid balance is important. Fluid administration must be adequate since both deficiency and excess can be detrimental. On one hand, too much fluid in a dehydrated patient may aggravate kidney injury, whereas too much fluid given to a patient suffering from kidney impairment may cause both fluid overload and respiratory distress. Severe cases of kidney injury must receive supportive care in the hospital, and for certain selected cases, dialysis may be necessary.

Prevention starts with early recognition:

The optimal method to minimise the chances of severe kidney complications is by detecting the warning signs at an early stage. A person who is infected with dengue should keep track of how much water is taken in and how much urine is produced, as well as listen to what the doctor has to say in terms of fluid intake, medications, and tests. Reduced urine output, continuing vomiting and bleeding, extreme fatigue and weakness, breathlessness, swelling, confusion, and increasing abdominal pain should be reasons for a person to seek immediate medical assistance. Starting off as a simple viral fever, dengue can evolve into more complicated forms in some cases. Monitoring urine output and other symptoms can help diagnose kidney disturbances at an early stage.

The author is the principal director, Nephrology and Kidney Transplant at Aakash Healthcare Multi-Speciality Hospital, Dwarka.

The opinions expressed in this article are those of the author and do not purport to reflect the opinions or views of THE WEEK. 

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