Comparative analysis of acute kidney injury in tropical infections: A retrospective cohort study

Abstract

Acute kidney injury (AKI) is a serious complication of tropical infections and a major contributor to morbidity and mortality. Renal outcomes vary across dengue, malaria, leptospirosis, and scrub typhus but are often poorly distinguished in practice. To compare clinical features, risk factors, and outcomes of AKI in four tropical infections. In this retrospective cohort study, 149 patients with AKI were included: dengue (34), malaria (34), leptospirosis (36), and scrub typhus (45). Clinical and laboratory data, dialysis requirement, and outcomes were analyzed over three months. Recovery rates were highest in dengue (85%) and malaria (91%), while leptospirosis (61%) and scrub typhus (67%) showed greater risks of CKD (20 -28%) and mortality (11 -13%). Poor outcomes correlated with older age, hypertension, elevated creatinine, and thrombocytopenia. Dengue and malaria are associated with better renal recovery, whereas leptospirosis and scrub typhus carry higher risks of CKD and mortality. Early recognition of predictors is essential. This study underscores the need to train healthcare learners to identify early predictors of AKI in tropical infections and to recognize that patients, especially with leptospirosis and scrub typhus, remain at risk for CKD, making structured post-discharge follow-up essential.