1772. Prevalence and Characteristics of Dengue Infection in US Dialysis Patients
Session: Poster Abstract Session: Viral Infections; Pathogenesis and Epidemiology
Saturday, October 5, 2013
Room: The Moscone Center: Poster Hall C
Posters
  • Dengue poster 1.pdf (527.1 kB)
  • Background: Dengue, caused by a mosquito transmitted virus, is associated with a spectrum of illness ranging from mild fever to hemorrhagic fever, septic shock, and death. Therapy is largely supportive. While dengue is uncommon in the continental United States (US), the virus is endemic to Puerto Rico and is an emerging infection in the Americas. A 2010 outbreak in Florida highlighted the potential for re-emergence of the disease in the US, an occurrence which would also impact the end stage renal disease (ESRD) population.  On this basis, this study queried the US Renal Data System (USRDS) to characterize the clinical features of ESRD patients diagnosed with dengue.

    Methods: All ESRD cases in the USRDS from 1978-2008 were queried for a diagnosis of dengue using ICD-9 diagnosis codes. Initial dialysis access type was used to categorize individuals as peritoneal dialysis (PD) or hemodialysis (HD).  Demographics and clinical covariates were identified from CMS Form 2728 or ICD-9 codes.  Patients were classified according to location of residence.

    Results: 62 patients (Puerto Rico (PR)=45, non-PR=17) were identified with a diagnosis of dengue. Dengue was the primary diagnosis in 55% PR and 65% non-PR. The most common causes of ESRD were diabetes mellitus (32.3%), unspecified renal failure (20.3%), and glomerulonephritis (18.6%).  Type of dialysis was reported in 63%, of which HD accounted for 70%. The majority of total patients were male (71.4%), Hispanic (87.1%), and below age 65 years (80.7%), with a mean age at diagnosis of 50 years. There were 1-4 cases per year, except in 1994 (9 cases), 1998 (16 cases), and 2007 (11 cases).  PR cases had a lower age at ESRD (45 vs 47 years for PR vs non-PR, respectively).  Average duration of dengue hospitalization (days) was as follows: All=6.8, PR=7.29, and non-PR=5.44. The mean time to death after hospitalization ranged from 1,564 days in PR to 2,364 days in non-PR.

    Conclusion: Among US citizens with ESRD, dengue was most commonly diagnosed in Puerto Rico and primarily affected patients below the age of 65 years. Episodic outbreaks were interspersed on a background annual rate of 1-4 cases. Infected patients had an average of 4.3 years to death after hospitalization for dengue, and suffered from similar primary causes of ESRD as the general population.

    Puja Chebrolu1, Kristina Kintziger, PhD, MPH1,2, Chan Jin1, Stephanie Baer, MD1,2, Christine Litwin, MD1, Mufaddal Kheda, MD1, N Stanley Nahman Jr., MD1,2 and Rhonda Colombo, MD1, (1)Georgia Regents University, Augusta, GA, (2)Charlie Norwood Vet., Augusta, GA

    Disclosures:

    P. Chebrolu, None

    K. Kintziger, None

    C. Jin, None

    S. Baer, Pfizer, Inc.: Grant Investigator, Research support

    C. Litwin, None

    M. Kheda, None

    N. S. Nahman Jr., None

    R. Colombo, None

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