Clinical and laboratory predictors of oliguric renal failure in haemorrhagic fever with renal syndrome caused by Hantaan virus

Abstract

Haemorrhagic fever with renal syndrome (HFRS), caused by hantavirus infection, develops into acute renal failure (ARF) of variable degrees of severity. We investigated the early predictive markers for oliguric ARF in HFRS patients. A retrospective cohort study was performed of 61 patients with HFRS between 2000 and 2004. These patients were categorized into either oliguric or non-oliguric ARF groups according to their urine output (<400 ml/24 h). The clinical characteristics were compared between the two groups. Of the 61 patients, 24 (39.3%) were classified as oliguric ARF and 37 (60.7%) as non-oliguric ARF. The peak serum Cr was 10.8 (IQR 9.1-12.4) mg/dl in oliguric ARF and 4.4 (IQR 3.1-6.0) mg/dl in non-oliguric ARF (p<0.001). The risk for developing oliguric ARF significantly increased in the cases with leukocyte count (> or =14 x 10(9)/L, aOR 2.2, 95% CI 1.0-4.9; p=0.039), elevated aspartate aminotransferase (> or =110 U/L, aOR 11.0, 95% CI 2.1-57.9; p=0.005) and the presence of microscopic haematuria (> or =5/HPF, aOR 9.2, 95% CI 1.4-60.3; p=0.021) at the time of admission. The leukocyte count, level of aspartate aminotransferase and microscopic haematuria at admission would be useful to predict for the subsequent development of oliguric ARF in HFRS.