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Hyponatremia, acute kidney injury, and mortality in HIV-related toxoplasmic encephalitis
Libório, Alexandre B.; Silva Jr, Geraldo B.; Silva, Carolina G.C.H.; Lima Filho, Francisco J.C.; Studart Neto, Adalberto; Okoba, Willy; Bruin, Veralice M.S. de; Araújo, Sônia M.H.A.; Daher, Elizabeth F..
  • Libório, Alexandre B.; Universidade de Fortaleza. Health Sciences Center. School of Medicine. Fortaleza. BR
  • Silva Jr, Geraldo B.; Universidade de Fortaleza. Health Sciences Center. School of Medicine. Fortaleza. BR
  • Silva, Carolina G.C.H.; Universidade de Fortaleza. Health Sciences Center. School of Medicine. Fortaleza. BR
  • Lima Filho, Francisco J.C.; Universidade de Fortaleza. Health Sciences Center. School of Medicine. Fortaleza. BR
  • Studart Neto, Adalberto; Universidade de Fortaleza. Health Sciences Center. School of Medicine. Fortaleza. BR
  • Okoba, Willy; Universidade de Fortaleza. Health Sciences Center. School of Medicine. Fortaleza. BR
  • Bruin, Veralice M.S. de; Universidade de Fortaleza. Health Sciences Center. School of Medicine. Fortaleza. BR
  • Araújo, Sônia M.H.A.; Universidade de Fortaleza. Health Sciences Center. School of Medicine. Fortaleza. BR
  • Daher, Elizabeth F.; Universidade de Fortaleza. Health Sciences Center. School of Medicine. Fortaleza. BR
Braz. j. infect. dis ; 16(6): 558-563, Nov.-Dec. 2012. ilus, tab
Article in English | LILACS | ID: lil-658927
ABSTRACT

BACKGROUND:

There are no reports on hyponatremia and acute kidney injury (AKI) involved in the course of HIV-related toxoplasmic encephalitis (TE). The main objective of this study was to describe the occurrence of hyponatremia and its relationship with AKI and mortality in HIV-related toxoplasmic encephalitis (TE).

METHODS:

This was a retrospective cohort study on patients with HIV-related TE. AKI was considered only when the RIFLE (risk, injury, failure, loss, end-stage) criterion was met, after the patient was admitted.

RESULTS:

A total of 92 patients were included, with a mean age of 36 ± 9 years. Hyponatremia at admission was observed in 43 patients (46.7%), with AKI developing in 25 (27.1%) patients during their hospitalization. Sulfadiazine was the treatment of choice in 81% of the cases. Death occurred in 13 cases (14.1%). Low serum sodium level correlated directly with AKI and mortality. Male gender (OR 7.89, 95% CI 1.22-50.90, p = 0.03) and hyponatremia at admission (OR 4.73, 95% CI 1.22-18.30, p = 0.02) were predictors for AKI. Independent risk factors for death were AKI (OR 8.3, 95% CI 1.4-48.2, p < 0.0001) and hyponatremia (or 9.9, 95% ci 1.2-96.3, p < 0.0001).

CONCLUSION:

AKI and hyponatremia are frequent in TE. Hyponatremia on admission is highly associated with AKI and mortality.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Toxoplasmosis, Cerebral / AIDS-Related Opportunistic Infections / Acute Kidney Injury / Hyponatremia Type of study: Etiology study / Incidence study / Observational study / Prognostic study / Risk factors Limits: Adult / Female / Humans / Male Language: English Journal: Braz. j. infect. dis Journal subject: Communicable Diseases Year: 2012 Type: Article Affiliation country: Brazil Institution/Affiliation country: Universidade de Fortaleza/BR

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Full text: Available Index: LILACS (Americas) Main subject: Toxoplasmosis, Cerebral / AIDS-Related Opportunistic Infections / Acute Kidney Injury / Hyponatremia Type of study: Etiology study / Incidence study / Observational study / Prognostic study / Risk factors Limits: Adult / Female / Humans / Male Language: English Journal: Braz. j. infect. dis Journal subject: Communicable Diseases Year: 2012 Type: Article Affiliation country: Brazil Institution/Affiliation country: Universidade de Fortaleza/BR