Acute Tubular Necrosis and Dengue

The recent article on “acute tubular necrosis and dengue” is very interesting. REPIZO et al. concluded that “serum creatine phosphokinase should be monitored in DF patients to allow for an early diagnosis of rhabdomyolysis and the institution of renal protective measures”. In fact, the renal complication of dengue is not rare and it should be kept in mind for all practitioners. The renal problem in dengue can be seen in either hemorrhagic or non-hemorrhagic cases. The underlying etiology of renal failure is believed to be due to the poor fluid management of the infected cases. The strong clinical relationship with fatality can be seen in such cases. The immunopathology seems to have little role in induction of acute tubular necrosis. The patient with a previous renal problem has a greater risk to develop renal failure. A careful follow-up of the fluid replacement therapy is the key factor for success in control and prevention of acute renal episode in dengue patients.