[Acute kidney failure caused by Hantaviruses].

Hantavirus-induced acute renal failure is a worldwide occurring disease and rarely known and diagnosed in Germany and in Western Europe. Its various clinical features are embraced by the term Hemorrhagic Fever With Renal Syndrome (HFRS). Cardinal symptoms of the mild European form called Nephropathia epidemica (NE) leading to diagnosis are: abrupt onset, fever, pain (abdominal, loin-, or headache), acute renal failure, proteinuria and/or hematuria, polyuria, and thrombocytopenia. Etiologic agent of NE is the vole transmitted Puumula-serotype of Hantaviruses. Severe courses of HFRS characterized by hemorrhagic complications occur in Asia and Southeast Europe and are caused by the serotypes Hantaan (Korean Hemorrhagic Fever), Seoul (rat associated) and Belgrade (both Epidemic Hemorrhagic Fever). Serological evidence of IgG and/or IgM-antibodies by indirect immunofluorescent antibody assay (IFA), enzyme linked immunosorbent assay (ELISA) or mu-capture-ELISA proves the diagnosis and allows distinction of the infecting virus type. Transmission occurs primarily through inhalation of virus contaminated aerosols or dust. Transmission between humans has never been observed. The incubation period ranges between four days to four weeks. All persons who have much outdoor activities in forests, open fields, farms, and nearby waters are at risk to be infected. Practical exposure prophylaxis seems rarely possible. Therapy of NE is only symptomatic, confined to the treatment of pain, diuretic therapy in oliguric patients, and volume and electrolyte substitution in volume depleted or polyuric patients. Sometimes temporary hemodialysis is needed. Renal history reveals commonly the pattern of acute interstitial nephritis with typical focal interstitial microhemorrhages.(ABSTRACT TRUNCATED AT 250 WORDS)