Ebola is a RNA virus that has a high rate
of transmission. As we have now noted
the world’s largest outbreak of this virus to date, the cure for this entity
remains a mystery. Ebola hemorrhagic fever is a severe infection. It can
have a mortality rate of up to 70-90%. The infection can occur in humans and
animals. The virus family is Filoviridae and genus Ebolavirus. It was
first discovered in 1970s near Ebola river in Congo. Since then most of the outbreaks have been in
Africa. While the natural reservoir host
of Ebola remains unknown, some believe it might be bats.
How does the kidney get involved? Severe
volume depletion from this hemorrhagic disease leads to acute kidney
injury. Electrolyte abnormalities such
as hyponatremia, hypokalemia and so forth can be noted as well. Renal
failure was described in this entity in early 1980s. DIC ensues and
a shock state leads to AKI. Prior animal studies
have shown that there is some necrosis and calcification in tubules and glomerular
tufts of kidney. The first victim in the US
in Texas was on dialysis
as well.
While some treatments and preventions are
being considered, there is only supportive therapy that can be offered at this
time. However, survival is improved by early supportive care with rehydration
and symptomatic treatment.
Early
intensive care therapy might be necessary.
What might be of interest to us as nephrologists is the
use of dialysis modalities to help clear the virus. Hemopurifier, a device from Aethlon Medical (San Diego, CA) that’s capable of
filtering blood of impurities like viruses is available. Apparently
it is being used currently ( per their report) for filtering the blood of an
infected doctor with the virus in Germany. The device can be used with standard
dialysis and continuous renal replacement therapy (CRRT) machines and doesn’t
require any special hardware upgrades.
More information regarding this can be found at the
website
http://www.medgadget.com/2014/10/aethlon-hemopurifier-now-filtering-blood-of-ebola-patient.html
Hello Dear.
ReplyDeleteI enjoyed your paper on Ebola and kidney.
Could I use this document to lecture on renal injury during Ebola?
Best Regards.