Topic Discussion: Ebola and the Kidney

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