Acute kidney injury and hyponatremia in hospitalized patients with rotavirus infection

Ulrike Hoffmann, Antje Rückner, Olaf Nickel, Kathrin Marx, Ralph Wendt

Abstract

Rotavirus is a common cause of infectious gastroenteritis in infants and children. The role of rotavirus infections in adults has potentially been underappreciated and there is a paucity of data on incidence and outcome of acute kidney injury in adult patients.

Introduction

As a major pathogen of viral gastroenteritis, rotaviruses repeatedly cause severe episodes of watery diarrhea, which is often accompanied by hospitalization, not least as a zoonotic and nosocomial infection. Infants under the age of five are particularly affected, but also immunosuppressed and immunosenescent patients.

Materials and methods

This retrospective, single-center cohort study complied with the Declaration of Helsinki and was approved by the Ethics Committee of the German-Saxonian Board of Physicians, Dresden, Germany (number, EK-BR-86/23–1). Adult patients hospitalized at the St. Georg Hospital Leipzig between 2012 and 2023 with microbiologically confirmed rotavirus infection and at least two serum creatinine measurements were included in this study.

Results

Overall, 314 hospitalized adult patients with rotavirus infection patients were evaluated, including 163 (51.9%) men and 151 women (48.1%). The mean age of the patients was 73.2 (± 15.6) years with 222 (70.7%) of patients older than 70 years.

Discussion

This is to the best of our knowledge the first report on incidence and outcome of acute renal injury (AKI) in adult hospitalized patients with rotavirus infections. There are only case reports on renal impairment in patients with rotavirus infections and exclusively in infants and children.

Conclusions

Patients with rotavirus infections and certain risk factor (age > 70 years and comorbidities, e.g., CKD) have a high risk of developing AKI. Outpatients with typical gastrointestinal symptoms suggestive of rotavirus infection and risk factors should seek medical attention with a low threshold.

Citation: Hoffmann U, Rückner A, Nickel O, Marx K, Wendt R (2026) Acute kidney injury and hyponatremia in hospitalized patients with rotavirus infection. PLoS One 21(2): e0326830. https://doi.org/10.1371/journal.pone.0326830

Editor: Tombari Pius Monsi, Rivers State University, NIGERIA

Received: June 12, 2025; Accepted: December 16, 2025; Published: February 19, 2026

Copyright: © 2026 Hoffmann et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: Data supporting the study findings are accessible from https://osf.io/q7cdy.

Funding: The author(s) received no specific funding for this work.

Competing interests: The authors have declared that no competing interests exist.