Chronic kidney disease as an aggravating factor in dengue virus infection

Background: Dengue virus infection is a public health problem worldwide, which can manifest from a mild febrile condition to severe disease, with multiple organ involvement, including kidney disease. The aim of this study was to analyze the most recent cases of dengue in the pre-COVID-19 era, assessing how chronic kidney disease (CKD) aggravates its clinical manifestations. Methods: A cross-sectional study was carried out using the database of the Health Secretariat of the state of Ceará, northeastern Brazil, in the period from January 2015 to December 2017. A comparison was made between patients with and without CKD. Results: A total of 161,880 patients were included. Patients with CKD were older (41±22 vs. 35±21 years, p<0.001), predominantly female (62 vs. 57%, p=0.004) and had a higher frequency of certain symptoms and signs. However, the only warning sign that was more prevalent among CKD patients was lethargy (0.5% vs. 0.004%, p=004). The most common comorbidities were hypertension and diabetes, which are also the most common causes of CKD (51 vs. 3.3% / 42 vs. 1.3%, p<0.001). Need for hospitalization was significantly more frequent in the group with CKD (12.3% vs. 2.2%, p<0.001), with mortality being higher in CKD patients (2.2% vs. 0.1%, p<0.001). Independent risk factors for death were: age, vomiting, leukopenia, diabetes, CKD and hypertension. Conclusions: CKD aggravates dengue severity, and people with this comorbidity should be carefully monitored, especially in epidemic periods.