Investigation of the relationship between proteinuria and urine protein/creatinine ratio and the severity of paediatric dengue fever

Abstract

Aim: The study was undertaken to establish early predictors of disease severity viz., urine protein creatinine ratio (UPCR) and proteinuria in children with dengue.Methods: A prospective study was conducted in the Department of Paediatrics in collaboration with pathology department for a period of 18 months, after taking the approval of the protocol review committee and institutional ethics committee. A total of 200 children were included in this study.Results: Out of the total, 41 were neonates, 57 were between the ages of 1 and 8 and 102 were children beyond the age of 8. This study included 140 Males and 60 Female children. An evident correlation was seen between elevated UPCR levels and the occurrence of bleeding symptoms, with statistical significance. An analysis revealed a statistically significant correlation between the use of inotropes and increased UPCR levels in the studied instances. The relationship between elevated UPCR levels and death demonstrated a substantial positive connection. Within our series, there were a total of 9 fatalities attributed to dengue fever. Among these cases, 5 children had proteinuria levels below 100 mg/dl, whereas 4 children had proteinuria levels beyond 100 mg/dl. The correlation was statistically significant.Conclusion: This study showed that UPRC is a reliable indicator for predicting the severity of the illness, the loss of fluid in the third space, bleeding symptoms, the need for inotropes, and unfavorable outcomes in children with dengue fever. Proteinuria of considerable magnitude was determined to be a valuable indicator for forecasting unfavorable consequences.