YU.A. TYURIN^1, 2, I.D. RESHETNIKOVA^1, 3, T.A. SAVITSKAYA¹, V.A. TRIFONOV¹, N.M. KHAKIMOV²

 ¹Kazan Research Institute for Epidemiology and Microbiology, Kazan

²Kazan State Medical University, Kazan

³Kazan (Volga) Federal University, Kazan

Contact details:

Tyurin Yu.A. — MD, Leading Researcher, Head of the Laboratory of Immunology and Allergen Development, Associate Professor of the Department of Biochemistry and Clinical Laboratory Diagnostics

Address: 67 Bolshaya Krasnaya St., 420015 Kazan, Russian Federation, tel.: +7 (843) 238-99-79, e-mail: tyurin.yurii@yandex.ru

A study of clinical and epidemiological features of hemorrhagic fever with renal syndrome (HFRS) in endemic regions of Russia (Volga and Ural Federal Districts) revealed high incidence of this disease (7.2/100,000 population) with summer-autumn seasonality. Analysis of 28 fatal cases (2.48% mortality) identified key risk factors: age >55 years, chronic kidney disease (CKD), late hospitalization (≥day 5), infectious-toxic shock, and delayed renal replacement therapy (RRT). Iatrogenic errors included inappropriate NSAID use and excessive fluid therapy. Recommendations include early diagnosis, timely RRT, and prevention in high-risk groups.

Key words: HFRS, mortality, endemic regions, risk factors.

REFERENCES

1. Klinicheskie rekomendatsii (protokol lecheniya) okazaniya meditsinskoy pomoshchi vzroslym bol’nym gemorragicheskoy likhoradkoy s pochechnym sindromom. Utverzhdeny Minzdravom RF, 2021 [Clinical guidelines (treatment protocol) for providing medical care to adult patients with hemorrhagic fever with renal syndrome. Approved by the Ministry of Health of the Russian Federation, 2021]. 48 p.
2. Ivanova A.V., Savitskaya T.A., Magerramov Sh.V., Neyshtadt Ya.A., Trifonov V.A., Reshetnikova I.D. et al. Hemorrhagic fever with renal syndrome: the current state of the problem in the Russian Federation and epidemiological risk assessment for 2025. Problemy osobo opasnykh infektsiy, 2025,  no. 2,  pp. 17–28 (in Russ.). DOI: 10.21055/0370-1069-2025-2-17-28
3. Tkachenko E.A., Dzagurova T.K., Bernshteyn A.D. et al. Risk factors for adverse outcomes in hemorrhagic fever with renal syndrome. Infektsionnye bolezni: novosti, mneniya, obuchenie, 2023,  vol. 12, no. 1,  pp. 78–85 (in Russ.). DOI: 10.33029/2305-3496-2023-12-1-78-85
4. Yashina L.N., Degtyareva A.V., Sludskiy A.A. et al. Modern features of the epidemiology and clinical picture of HFRS in the Middle Volga region: analysis of fatal outcomes. Epidemiologiya i vaktsinoprofilaktika, 2022,  vol. 21, no. 2,  pp. 45–52 (in Russ.). DOI: 10.31631/2073-3046-2022-21-2-45-52
5. Kozlov V.K., Poleshchuk E.M. Acute renal failure in hemorrhagic fever with renal syndrome: management tactics and prognosis. Nefrologiya, 2021,  vol. 25, no. 3,  pp. 45–53 (in Russ.).
6. Khamitova R.M., Garipova A.R., Valeev R.V. The impact of premorbid nephropathy on the course and outcomes of hemorrhagic fever with renal syndrome. Terapevticheskiy arkhiv, 2020,  vol. 92, no. 10,  pp. 65–70 (in Russ.). DOI: 10.26442/00403660.2020.10.000756
7. Tkachenko E.A., Dzagurova T.K., Bershteyn A.D. et al. Hemorrhagic fever with renal syndrome — a problem of the 21st century. Vestn. Rossiyskoy Akademii estestvennykh nauk, 2012,  vol. 12, no. 1,  pp. 48–54 (in Russ.).
8. Rekomendatsii po primeneniyu metodov ekstrakorporal’noy detoksikatsii v lechenii OPN pri GLPS. Pis’mo Minzdrava RF no. 15-4/I/2-12295 ot 15.12.2022 [Recommendations for the use of extracorporeal detoxification methods in the treatment of acute renal failure in HFRS. Letter of the Ministry of Health of the Russian Federation No. 15-4/I/2-12295 dated 12/15/2022].
9. Bekhtereva M.K., Abramov D.D. Iatrogenic complications in hemorrhagic fever with renal syndrome: analysis of errors. Klinicheskaya meditsina, 2021,  vol. 99, no. 7,  pp. 534–539 (in Russ.). DOI: 10.30629/0023-2149-2021-99-7-534-539
10. Avšič-Županc T., Saksida A., Korva M. Hantavirus infections. Clin. Microbiol. Infect, 2019,  vol. 21S, pp. e6–e16. DOI: 10.1111/1469-0691.12291
11. Vaheri A., Strandin T., Hepojoki J. et al. Uncovering the mysteries of hantavirus infections. Nat. Rev. Microbiol, 2013,  vol. 11 (8),  pp. 539–550. DOI: 10.1038/nrmicro3066
12. Federal’naya sluzhba po nadzoru v sfere zashchity prav potrebiteley i blagopoluchiya cheloveka (Rospotrebnadzor). Gosudarstvennye doklady «O sostoyanii sanitarno-epidemiologicheskogo blagopoluchiya naseleniya v Rossiyskoy Federatsii» za 2019–2024 gg. Razdel «Infektsionnaya zabolevaemost» [Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing (Rospotrebnadzor). State reports «On the state of sanitary and epidemiological well-being of the population in the Russian Federation» for 2019–2024. Section «Infectious morbidity»], available at: https://www.rospotrebnadzor.ru/?ysclid=mfva1n99l542276822