47 Glomerular Filtration Rate in Convalescents with Hemorrhagic Fever with Renal Syndrome
Objectives Bosnia and Herzegovina is a known endemic region for Hantavirus infection. In this region at least two different Hantaviruses, the Dobrava viruses (DOBV) and Puumala viruses (PUUV) have been found. The aim of the study was to determine glomerular filtration rate (GFR) in patients with a history of hemorrhagic fever with renal syndrome (HFRS) 9 to 10 years after the acute phase of the disease. Design and Methods We prospectively reviewed clearance of technetium marked diethyl three amino pentacetic acid (Tc99m DTPA) in 42 male convalescents with serologically confirmed HFRS, 13 patients with PUUV infection and 29 patients with DOBV infection. Results The tubulosecretory phase of the GFR was prolonged in six patients (46%) with PUUV infection and 23 patients (79%) with DOBV infection (P < 0.05). Total and separate clearance EDTA were significantly statistically lower (P < 0.001) in patients with serologically confirmed DOBV infection. In patients with DOBV infection elimination of radio pharmac was prolonged. Conclusions Hemorrhagic fever with renal syndrome can cause sustained renal damage that very rarely progresses into renal failure. The tubulosecretory DTPA phase was prolonged in 46% of examinees with PUUV and in 79% of examinees with DOBV infection. Elimination of radio pharmac from the kidney was prolonged in both groups of patients. The DTPA clearance rate was lower in patients with serologically confirmed HFRS than in normal populations, especially in patients with DOBV infection.