Hepatic and Renal Dysfunction in Adults with Acute Dengue Infection: Incidence, Clinical Predictors, Interrelationship and Short-Term Outcomes—A Prospective Observational Cohort Study

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Background: Dengue infection may cause significant hepatic and renal dysfunction, contributing to increased disease severity and adverse clinical outcomes. This study assessed the incidence, clinical predictors, interrelationship and short-term outcomes of hepatic and renal dysfunction among adults with acute dengue infection. Methods: This prospective observational cohort study was conducted in the Department of Medicine, Mugda Medical College, Dhaka, Bangladesh, from July to December 2025. A total of 120 adult patients with laboratory-confirmed acute dengue infection were enrolled consecutively. Socio-demographic, clinical and laboratory data were collected and patients were followed throughout hospitalization. Data were analyzed using SPSS version 25, with p<0.05 considered statistically significant. Results: Hepatic dysfunction was observed in 43.3% of patients, whereas renal dysfunction occurred in 19.2%. Concurrent hepatic and renal dysfunction was present in 14.2%. Elevated AST and ALT levels were found in 53.3% and 40.8% of patients, respectively. Warning signs were significantly more frequent among patients with hepatic and renal dysfunction, as were severe thrombocytopenia and hypotension or shock. Both hepatic and renal dysfunction were significantly associated with ICU/HDU admission and hospital stay exceeding five days (p<0.001). Mortality occurred only among patients with organ dysfunction. Conclusion: Hepatic and renal dysfunction are important complications of acute dengue infection and are associated with markers of severe disease and unfavorable short-term outcomes. Early identification and close monitoring of organ dysfunction may improve risk stratification and clinical management.

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