Abstract

CORREA, Daiana et al. Proteinuria associated with dengue. Rev. virtual Soc. Parag. Med. Int. [online]. 2014, vol.1, n.1, pp.18-27. ISSN 2312-3893.  https://doi.org/10.18004/rvspmi/2312-3893/2014.01(01)18-027.

Objectives: To describe the degree of proteinuria and serum albumin in patients with dengue and correlate the proteinuria with the capillary leakage measured by the level of hemoglobin and hematocrit hemoconcentration. Methods: This was a cross-sectional, prospective, descriptive and observational study. Study population: adult men and women, dengue carriers and admitted in the Department of Internal Medicine between December 2012 and May 2013. Inclusion criteria: severe dengue with warning signs, confirmed by positive NS1 antigen and/or IgM in post-febrile or critical period. Exclusion criteria: known kidney disease carriers. Non-probabilistic sampling of consecutive cases. Variables: demographic data, hemogram, 24-hour proteinuria, serum albumin. Results: Twenty six men with a mean age of 42 ± 21 years and 28 women with a mean age of 41±21 years were included in the study. Proteinuria was detected in 43 subjects (79.6%). The proteinuria was in nephrotic range (mean 3,184±916 mg/24 h) in 8 cases (14.8%) and in high values (mean 669±494 mg/24 h) in 35 cases (64.8%). The serum albumin was 3±0.7 mg/dL in patients with nephrotic range, 2.9±0.4 mg/dL in those with high levels of proteinuria and 2.6±0.4 mg/dL (p=0.09 ANOVA test) in subjects without proteinuria. The correlation between the proteinuria and degree of hemoglobin hemoconcentration was -0.01 while the correlation between the proteinuria and degree of hematocrit hemoconcentration was -0.04. Conclusions: Proteinuria associated with dengue was observed in 79.6% of the patients reaching the nephrotic range in 14.8%. The proteinuria was not associated with the degree of hemoglobin or hematocrit hemoconcentration, the parameters commonly used as indicators of the severity of the capillary leakage. It is recommended to add protein dosage in 24-hour urine in the treatment protocol of dengue as well as the prospective follow-up of those patients with nephrotic range.

Keywords : dengue; proteinuria; nephrotic syndrome.

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