ORLANDO — When patients who’ve had a West Nile virus infection develop chronic kidney disease (CKD), it’s unlikely that traditional risk factors play a role, a case-control study suggested.
For instance, hypertension is a typical risk factor for kidney disease, yet controls who’d never had the virus were more likely to have hypertension than those who had had West Nile virus — 64% controls versus 45% of West Nile cases (OR 0.45, 95% CI 0.23 to 0.91,P=0.026), Melissa Nolan, MPH, of Baylor College of Medicine in Houston, and colleagues reported during a poster session at the National Kidney Foundation meeting here.
They did find that case patients with stage 3 to 5 CKD had significantly greater odds of having proteinuria than controls (OR 2.79, P=0.05).
“Proteinuria is a distinguishing biomarker between those with and without West Nile-related kidney disease,” Nolan and colleagues wrote.
Bill Schaffner, MD, an infectious disease specialist at Vanderbilt University in Nashville, Tenn., toldMedPage Today that Nolan’s group has had some of the “best long-term follow-up of West Nile survivors,” and that the virus’s link to delayed kidney disease “seems to be a valid phenomenon.”
The virus has been shown to cause persistent infection in animals, with the kidney being a preferred site of replication.
Nolan’s group had previously reported a case series of 139 patients who’d had West Nile virus; 40% of the survivors had chronic kidney disease — a much higher prevalence than expected.
Furthermore, a history of neuroinvasive disease had been the only significant predictor of disease in this population: “They don’t have diabetes, they don’t have hypertension,” Nolan told MedPage Today.
To advance the strength of their evidence, she and her colleagues conducted a matched case-control study with those 139 West Nile survivors, who had a mean age of 65.
Controls who’d never had West Nile were recruited from a University of Texas physician’s renal clinic from May 2012 to March 2013, and matched 2-to-1 to cases based on age, race/ethnicity, gender, and CKD stage.
In a multivariate regression analysis, Nolan and colleagues found that although hypertension didn’t appear to be behind the development of kidney disease in the cases, tobacco use did appear to be a risk factor for cases compared with controls, they reported.
“Smoking cessation could help minimize any further renal deterioration in this population,” they wrote.
Although she cautioned against speculation about possible causes for the eventual decline in renal function in patients previously infected with West Nile virus, Nolan suggested the virus “could be causing chronic persistent infection in the kidney tubules, causing inflammation.”
Schaffner pointed out that patients involved in the study were of lower socioeconomic status, which may also play some role in pathogenesis.
He added that delayed kidney disease isn’t common in any other viral infections and is “quite distinctive” to West Nile.
3619 Ambassador Caffery Pkwy. Bldg E
Lafayette, LA 70503
Next to Bed, Bath and Beyond
If you’re looking for high quality, personal service you’ve come to the right place. At MinuteMed Walk-In Medical Clinic (Lafayette Walk In Clinic) & Urgent Care in Lafayette, Louisiana, we’ll give you the attention and personal service you’ll come to expect and enjoy. Walk-Ins are welcome or you can go to our “Contact Us” page and give us a call to schedule an appointment!
MinuteMed is conveniently located with three locations in Lafayette, LA – Johnston Office, Ambassador Office and Verot Office. Let us put our experience to work for you. Our rates are competitive, with no hidden fees and no long wait times. Our employees are friendly and will be there to help you every step of the way.
Lafayette Medical Services from MinuteMed Walk in Clinic & Urgent Care Facility is designed to provide affordable and timely minor medical and primary care to individuals in our community. Our Acadiana Walk In Clinic will offer services of experienced and friendly physicians and nurse practitioners to provide patients with thorough assessments, diagnosis, and treatment of minor ailments, as well as screening, preventative medicine, and health education.
Our services include but are not limited to:
MinuteMed Walk In Clinic Accepts All Private Insurances if not currently Enrolled we will attempt to include your insurance Company and charge you at the Insurance company rate.
MinuteMed Walk In Clinic does not accept Medicare or Medicaid
We Proudly Accept BE (Business Express)
Those without any healthcare coverage. Those who only have major catastrophic or high deductible policies. Small business owners as part of a benefits package. Business owners looking for a less expensive option for minor medical care for their full-time or part-time employees. Business who are self-insured.
Policy Holders pay only $20 per office visit. Your policy benefits include The office visit. Treatment of your minor illness and injuries including but not limited to – allergy symptoms, coughs, flu-like symptoms, pink eye & styes, sore throat, urinary tract infection, skin conditions, cuts & lacerations, sprains & strains. Any required in-house lab work (US, UPT, rapid strep test, blood sugar, flu test, urine drug screen). Discounts on in-house prescription medications. Annual influenza vaccine (no office visit charge). Annual physicals for work or school and Much More.
Individual policies cost is a reasonable $50.00 per month per yearly contract effective the next business day. $20.00 exam fee per visit. $200.00 per month for a family of 4 or more. Optional $120.00 per member sign up fee. ($100.00 activation fee plus $20.00 exam fee. Allows policy to take effect same day and covers full price of your visit). May cancel the policy at any time after six months with written notice. You will not be denied a policy due to previously existing conditions.