Sir,
The Middle East respiratory syndrome coronavirus infection is the present public health problem. At present, the serious new emerging infection is reported in many new settings including to East Asia. The infection is usually an acute febrile illness with severe respiratory problems. However, the other systemic problem can also be seen. In nephrology, the infection on cases with underlying renal failure problem is very interesting. Similar to any other new emerging disease, the patients with the renal problem can get the infection and the severe clinical feature can be expected. According to a recent publication by Shalhoub et al., the very high mortality rate (100%) could be observed in renal failure patients infected with the Middle East respiratory syndrome coronavirus.Citation1 Of interest, the standard antiviral, ribavirin therapy is found to be ineffective for the management of infection in cases with underlying renal failure.Citation2 In addition, according to a recent case-control study, having the end-stage renal disease in cases with pneumonia is a risk of severe infection.Citation3 Indeed, the infection can also induce acute renal injuryCitation4–6 and this might superimpose the patient with an underlying renal problem. In cases with viral-induced acute renal failure, the disappearance of virus in the urine sample is the important observation when renal failure occurs.Citation7 Accompanied with respiratory failure, acute renal failure can be the cause of death in the severely infected cases.Citation8 It is no doubt that the patients with underlying chronic renal problem especially those on hemodialysis have a high risk to get disease transmission from the other patients.Citation9 Finally, the Middle East respiratory syndrome coronavirus infection among the patients with renal transplantation is also reported.Citation10 AlGhamdi et al. reported on “variable clinical presentations and outcome” among these patients.Citation10 In conclusion, renal failure can be the important problem in the Middle East respiratory syndrome coronavirus infection. The infection can induce renal failure. In addition, the patient with underlying renal failure can have a high risk to get an infection and if they get an infection, severe clinical features can be expected. The closed monitoring of renal function among the patients with the Middle East respiratory syndrome coronavirus infection is suggested.
Declaration of interest
The authors report no conflicts of interest.
Beuy Joob
Sanitation 1 Medical Academic Center
Bangkok, Thailand
Viroj Wiwanitkit
Visiting Professor, Tropical Medicine Unit,
Hainan Medical University, China
Faculty of Medicine, University of Nis, Serbia
Joseph Ayobabalola University
Received 6 October 2015; accepted 22 November 2015
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