Dengue: A Growing Public Health Problem in Europe with Potential Severe Renal Involvement

Abstract

Dengue is an arboviral infection transmitted by the mosquito of the Aedes genus, widespread especially in tropical and subtropical regions but now with worldwide involvement. Cases of contagion are also progressively increasing in Europe, and the differential diagnosis with other infections is not always easy. Renal involvement with acute renal failure is possible and caused by the direct action of the virus, hemodynamic instability, rhabdomyolysis, or acute glomerular damage. In patients most at risk of renal involvement, there is high morbidity and mortality, with more extended hospital stays and follow-ups over time, which increases the burden on healthcare systems. Knowledge of this infection by nephrologists is essential for reducing morbidity, mortality, and, therefore, healthcare costs.

Keywords: Acute kidney failure, Arbovirus, classical Dengue fever, Dengue hemorrhagic fever, Dengue shock syndrome, early diagnosis

Introduction 

The dengue virus, responsible for the disease, is an arbovirus with four antigenically and genetically distinct DENV serotypes (DENV1–4). It is an important mosquito-borne viral infection, once confined to tropical and subtropical regions but now it is a growing global public health concern.
DENV has a single-stranded RNA genome composed of three structural protein genes: core protein (C), a membrane-associated protein (M), an envelope protein (E) and seven nonstructural protein (NS) genes, and glycoprotein NS1 has diagnostic importance. Infection with any serotype confers lifelong immunity to that viral serotype. However, in cross immunity for the other serotypes, the recovery is only partial, and temporary. Genetic variation within each serotype is called “subtypes” or “genotypes”. Currently, three subtypes are identified for DENV-1, six for DENV-2, four for DENV-3, and four for DENV-4.