With the onset of respiratory illness season, a relatively lesser-known virus Human Metapneumovirus (HMPV) is raising infections in China and some other parts of the world including India. While many fear it could trigger another pandemic given its similarities to Covid-19, experts say one need not worry about its rapid spread. The virus causes mild flu-like symptoms like fever, cough, nasal congestion and difficulty breathing, but can cause severe complications in vulnerable populations like children, especially infants below 1 year, among elderly, or those who are immunocompromised.
What is Human Metapneumovirus (HMPV)?
Human Metapneumovirus (HMPV) is a respiratory virus primarily affecting the upper and lower respiratory tracts. It commonly causes symptoms such as fever, cough, nasal congestion, and difficulty breathing.
Can HMPV affect kidneys?
Many wonder if HMPV like Covid can affect other organs of the body, including the kidneys. Experts say there is some evidence around the virus having indirect effect on kidney. TOI Lifestyle spoke to nephrologists and pulmonologists to understand.
HMPV primarily targets the respiratory system, but like many viral infections, it may have effects on other organs in severe cases.
Cytokine storm can impair kidney function
“The kidneys are the excretory system of the body. All the waste and toxins are filtered through the kidney. In case of any severe infection there is multisystem involvement and kidneys are vulnerable to damage. Although direct kidney involvement with HMPV is rare. This virus can lead to complications such cytokine storm triggered by a severe immune response which could potentially impair kidney function, usually kidney functions recover with the recovery of patients clinical conditions however in few cases patient might require dialysis also,” Dr. Anuja Porwal, Director – Nephrology, Fortis Hospital, Noida told TOI Lifestyle.
HMPV can cause acute kidney injury
The virus can lead to acute kidney injury (AKI) in some patients and there is a study that established this connection.
“There is some evidence of an association between infection with hMPV and renal problems, mainly acute kidney injury (AKI). A study on hospitalized children in the United States reported that infection with HMPV may be associated with a higher risk of AKI. This study adds some credibility to a possible connection between HMPV infections and kidney diseases, but further studies are required to clarify the relationship,” says Dr Mohit Khirbat, Consultant, Nephrology, CK Birla Hospital, Gurugram.
Hypoxia can impair kidney blood flow
Direct kidney involvement is rare, but the virus may indirectly impact kidney function through complications such as systemic inflammatory response syndrome (SIRS), which can lead to multi-organ dysfunction and acute kidney injury (AKI).
“Severe respiratory infections caused by HMPV may also result in hypoxia, where reduced oxygen levels impair kidney blood flow, further compromising function. Dehydration due to high fever, vomiting, or reduced oral intake during the illness can decrease kidney perfusion, potentially leading to prerenal AKI,” says Dr Nikhil Modi, Senior Consultant for Respiratory Critical Care at Indraprastha Apollo Hospital.
“Secondary bacterial infections or sepsis—a known complication of viral infections—can exacerbate kidney damage,” says Dr Modi.
Who are at risk of kidney complications from HMPV?
Patients with pre-existing kidney disease or patients who have risk factors for kidney involvement are especially prone for severe kidney involvement. In other patients kidney involvement is usually mild.
Signs and symptoms of kidney issues with HMPV
If HMPV indirectly affects the kidneys, patients may exhibit signs of kidney dysfunction. Symptoms include reduced urine output, swelling in the legs or face, fatigue, confusion. Blood tests show elevated creatinine or urea levels.
“One will experience decreased urine output, facial puffiness and leg swellings if HMPV virus involves kidneys. Kidney involvement in those infected with HMPV can be known by testing for simple blood and irons tests such as Serum Creatinine, blood urea and complete urine examination,” says Dr. P S Vali, Senior Consultant Nephrologist (Head of the Dept), Asian Institute of Nephrology and Urology Hyderabad.
How the virus impacts kidneys
While HMPV itself does not directly target kidney cells, complications from the infection could create a cascade of effects. For instance:
– Dehydration from high fever or reduced fluid intake can strain the kidneys.
– Sepsis, a severe systemic infection, can reduce blood flow to the kidneys, causing damage.
– Inflammation from the body’s immune response may impair renal function.
Kidney-specific HMPV signs to watch out for as per Dr Khirbat:
Decreased urine production: This may represent impaired kidney function.
Swelling: Especially in the legs, ankles, or around the eyes, which may result from fluid retention due to weakened kidney function.
Fatigue: Another common symptom, not only with kidney issues but with HMPV infection as well.
Shortness of breath: Although more characteristically related to HMPV’s respiratory consequences, it is also a manifestation of fluid retention secondary to renal impairment.
Nausea and vomiting: In some cases, these can be related to the kidneys.
To reduce your risk of kidney failure, Dr Vali shares the following tips:
– Maintain good hydration. Consume large amounts of liquids to prevent dehydration.
– Avoid unnecessary use of painkillers. For general pains, one can use Paracetamol tablet, which is considered safe for kidneys
– Be watchful about kidney symptoms such as decreased urine output, facial puffiness and leg swellings.
(Picture courtesy: iStock)
