Renal Involvement in West Nile Virus Infection: A Systematic Review and Meta-Analysis

Introduction:

West Nile virus (WNV) is a neurotropic pathogen with an increasing clinical significance. This pathogen is responsible for recurrent outbreaks of meningitis and encephalitis worldwide. Severe cases can be fatal or result in long-lasting sequelae. While its impact on the central nervous system is well documented, recent evidence also suggests potential peripheral manifestations of WN disease, including renal involvement. The aim of this study was to evaluate alterations in renal function parameters in infected patients through a systematic review and meta-analysis.

Methods:

A systematic literature search was conducted in PubMed following PRISMA 2020 guidelines to identify studies reporting numerical data on biochemical markers of kidney function in hospitalized individuals infected with WNV. Several kidney function markers were analyzed, namely serum creatinine, blood urea nitrogen (BUN), sodium, potassium, calcium, bicarbonate, magnesium, hemoglobin, and estimated glomerular filtration rate (eGFR).

Results:

Data suggested that many patients showed signs of kidney issues. Creatinine levels were high in most of the patients, and BUN was elevated in about two-thirds of patients. Low sodium levels (hyponatremia) were common. Nearly half the patients had moderately reduced eGFR, and some had values suggesting serious kidney failure. Other markers like potassium, calcium, and magnesium did not show consistent patterns, likely because of the low number of available data.

Conclusions:

Our findings suggest that WNV infection often has effects on the kidneys. The results here described invite caution and more attention to renal function in WNV-infected patients, which may reduce the complications associated with infection and improve the outcome of the patients.