DOI: 10.1177/09760016261459254 ISSN: 0976-0016

Clinical Spectrum and Risk Factors of Renal Involvement in Paediatric Dengue: A Prospective Observational Analysis from India

Rufaida Mazahir, Shahzad Alam, Maaz Ozair
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Background and Aims:

Renal involvement is an increasingly recognised but under-reported complication of paediatric dengue. Data from the Indian subcontinent, particularly using the standardised acute kidney injury (AKI) definition (Kidney Disease: Improving Global Outcome [KDIGO]) and prospective design, remain limited. Hence, this study was undertaken with the aim to describe the clinical spectrum of renal involvement in children with dengue and identifying the associated risk factors.

Methods:

This prospective observational study was conducted between 1st March and 30th November 2025 at a tertiary care hospital in northern India in children ≤18 years having dengue infection. Clinical, laboratory and outcome data were collected and analysed.

Results:

Among 152 children ≤18 years (median age 108 months) admitted with confirmed dengue, renal involvement was observed in 42.1% ( n = 64). Haematuria was seen in 23.7%, proteinuria in 22.3%, and AKI in 17.8%, with most AKI being Stages 1 or 2; only one child required dialysis. Children with renal involvement more often had severe dengue, clinical bleeding, clinical fluid overload, neurological involvement, hepatomegaly, hypoalbuminemia, severe thrombocytopenia and had higher serum creatinine and prolonged international normalised ratio. On multivariable analysis, older age (aOR = 1.028; 95% CI: 1.004–1.053; P = .020) and hepatomegaly (aOR = 18; 95% CI: 1.7–198; P = .017) were independent predictors of renal involvement. Length of hospital stay and in-hospital mortality were not significantly different between groups.

Conclusion:

Renal involvement is common in hospitalised children with dengue, but is usually mild and reversible. Hepatomegaly can serve as a simple bedside marker to identify children at higher risk who require closer renal monitoring and timely supportive care.

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