Science and Innovations in MedicineScience and Innovations in Medicine2500-13882618-754XFSBEI of Higher Education SamSMU of Ministry of Health of the Russian Federation9635410.35693/2500-1388-2022-7-1-35-38Research ArticlePrediction of chronic kidney disease in patients with hemorrhagic fever with renal syndromeStulovaMariуa V.<p>assistant of the Department of Infectious diseases with epidemiology</p>mariastulova@gmail.comhttps://orcid.org/0000-0002-6169-1701KonstantinovDmitrii Yu.<p>PhD, Associate professor, Head of the Department of Infectious diseases with epidemiology</p>dk.samgmu@mail.ruhttps://orcid.org/0000-0002-6177-8487PopovaLarisa L.<p>PhD, Professor of the Department of Infectious diseases with epidemiology</p>ll_popova@mail.ruhttps://orcid.org/0000-0003-0549-361XLyubushkinaAnna V.<p>PhD, assistant of the Department of Infectious diseases with epidemiology</p>a.lyubushkina@mail.ruhttps://orcid.org/0000-0002-0348-9118NedugovGerman V.<p>PhD, Associate professor of the Department of Forensic medicine</p>nedugovh@mail.ruhttps://orcid.org/0000-0002-7380-3766Samara State Medical University150120227135381301202201022022Copyright © 2021, Stulova M.V., Konstantinov D.Y., Popova L.L., Lyubushkina A.V., Nedugov G.V.2021<p><strong>Aim</strong> to develop, using mathematical and statistical analysis of clinical, laboratory and instrumental data, a method for predicting the development of chronic kidney disease (CKD) in patients with hemorrhagic fever with renal syndrome (HFRS).</p>
<p><strong>Material and methods. </strong>244 patients at the age from 18 to 50 years with a confirmed diagnosis of HFRS were examined. Patients were observed in the following periods: oliguric, polyuric, early (30th day of illness) and late (90th and 180th day of illness) convalescence. Clinical, laboratory and instrumental data, including computer photoplethysmography, were evaluated.</p>
<p><strong>Results.</strong> Prediction of CKD in patients with HFRS (polyuria period) based on a linear discriminant model is possible with an accuracy index of 92.2%. In subsequent periods, the accuracy index increases: in early convalescence 98.4%, in late convalescence up to 100%. The following markers were the most informative: RI before ischemia, leukocytes and platelets in the general blood test, total protein and creatinine in the biochemical blood test, GFR calculated using the CKD-EPI and MDRD formulas, daily microalbuminuria, BMI and weight.</p>
<p><strong>Conclusion.</strong> A complex of discriminant models for predicting the development of CKD in patients with HFRS at various stages of the disease, including convalescence, with an accuracy index from 92 to 100% has been developed. These models are implemented in the software "Calculator for predicting CKD after HFRS".</p>hemorrhagic fever with renal syndromeearly and late convalescenceprognosis of chronic kidney diseasecomputer photoplethysmographydiscriminant analysisгеморрагическая лихорадка с почечным синдромомранняя и поздняя реконвалесценцияпрогнозирование хронической болезни почеккомпьютерная фотоплетизмографиядискриминантный анализ[Aftaeva LN, Melnikov VL, Nikolskaya MV, Duvanova EA. Clinical and epidemiological features of the course of HFRS, depending on the severity. In: Scientific dialogue: Questions of medicine. Saint-Petersburg, 2018. (In Russ.). [Афтаева Л.Н., Мельников В.Л., Никольская М.В., Дуванова Е.А. Клинико-эпидемиологические особенности течения ГЛПС в зависимости от степени тяжести. В кн.: Научный диалог: Вопросы медицины. Санкт-Петербург, 2018]. Available at: https://www.elibrary.ru/item.asp?id=32473236 Accessed December 11, 2021 doi: 10.18411/spc-15-02-2018-01][Noack D, Goeijenbier M, Reusken CBEM, et al. Orthohantavirus Pathogenesis and Cell Tropism. Front Cell Infect Microbiol. 2020;10:399. doi: 10.3389/fcimb.2020.00399][Manakhov KM, Melnikov AV, Dudarev MV, et al. Assessment of myocardial blood supply in convalescents of hemorrhagic fever with renal syndrome. In: Proceedings of the Izhevsk State Medical Academy. Izhevsk, 2020. (In Russ.). [Манахов К.М., Мельников А.В., Дударев М.В., и др. Оценка кровоснабжения миокарда у реконвалесцентов геморрагической лихорадки с почечным синдромом. В кн.: Труды Ижевской государственной медицинской академии. Ижевск, 2020]. Available at: https://www.elibrary.ru/item.asp?id=44509851 Accessed December 11, 2021.][Dudarev MV, Pimenov LT. Long-term outcomes and formation of chronic disease of the kidneys in patients with a history of hemorrhagic fever with renal syndrome. Therapeutic archive. 2008;(80):59–62. (In Russ.). [Дударев М.В., Пименов Л.Т. Отдаленные исходы и формирование хронической почечной недостаточности у перенесших геморрагическую лихорадку с почечным синдромом. Терапевтический архив. 2008;(80):59–62].][Kuznetsova LV, Khrustaleva EV, Shutov AM. Chronic kidney disease in patients with previous hemorrhagic fever with renal syndrome. Proceedings of higher educational institutions. Volga region. Medical sciences. 2012;3(23):60–66. (In Russ.). [Кузнецова Л.В., Хрусталева Е.В., Шутов А.М. Хроническая болезнь почек у больных, перенесших геморрагическую лихорадку с почечным синдромом. Известия высших учебных заведений. Поволжский регион. Медицинские науки. 2012;3(23):60–66].][Mukhetdinova GA, Boris GD, Fazlyeva RM, et al. Cardiovascular risk and chronic kidney disease in convalescents of hemorrhagic fever with renal syndrome. Practical medicine. 2019;2 (17):94–98. (In Russ.). [Мухетдинова Г.А., Борис Г.Д., Фазлыева Р.М., и др. Сердечно-сосудистый риск и хроническая болезнь почек у реконвалесцентов геморрагической лихорадки с почечным синдромом. Практическая медицина. 2019;2(17):94–98].][Klingström J, Smed-Sörensen A, Maleki KT, et al. Innate and adaptive immune responses against human Puumala virus infection: immunopathogenesis and suggestions for novel treatment strategies for severe hantavirus-associated syndromes. J Intern Med. 2019;285(5):510–523. doi: 10.1111/joim.12876][Jiang H, Du H, Wang LM, et al. Hemorrhagic fever with renal syndrome: pathogenesis and clinical picture. Front Cell Infect Microbiol. 2016;6:1. doi: 10.3389/fcimb.2016.00001][Strandin T, Mäkelä S, Mustonen J, Vaheri A. Neutrophil activation in acute hemorrhagic fever with renal syndrome is mediated by hantavirus-infected microvascular endothelial cells. Front Immunol. 2018;9:2098. doi: 10.3389/fimmu.2018.02098][Korva M, Rus KR, Pavletič M, et al. Characterization of biomarker levels in Crimean-Congo hemorrhagic fever and Hantavirus fever with renal syndrome. Viruses. 2019;11(8):686. doi: 10.3390/v11080686]