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Ellen Krautkrämer, Martin Zeier, Alexander Plyusnin 

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1 Hantavirus infection: an emerging infectious disease causing acute renal failure 
Ellen Krautkrämer, Martin Zeier, Alexander Plyusnin  Kidney International  Volume 83, Issue 1, Pages (January 2013) DOI: /ki Copyright © 2013 International Society of Nephrology Terms and Conditions

2 Figure 1 Nadir level of platelet count is predictive for severe renal failure. Course of serum creatinine levels (a) and platelet counts (b) in patients with milder or severe acute renal failure during nephropathica epidemica (NE). Mean values and s.d. are shown. Mean values of mild cases were compared with those of severe courses using Student’s t-test (*P<0.05; **P<0.01; ***P<0.0001). Levels of platelets increased significantly faster in milder than in severe courses of NE. In milder courses, platelets reached values of the lower limit of the reference range (150–440G/l) within the first week after illness onset, whereas in severe courses platelet counts at day 5 and 6 were still very low. Interestingly, creatinine levels up to day 6 after the onset of symptoms were equal, and although milder courses then showed a continuous decrease, creatinine levels increased suddenly at day 7 in severe courses. Kidney International  , 23-27DOI: ( /ki ) Copyright © 2013 International Society of Nephrology Terms and Conditions

3 Figure 2 Hantavirus infection disrupts cell-to-cell contacts. Human renal glomerular endothelial cells were infected with hantavirus Puumala and analyzed for the expression of hantaviral N antigen (red) and localization of the tight junction marker protein ZO-1 (green) by immunofluorescence. The left image shows uninfected human renal glomerular endothelial cells with well-organized cell-to-cell contacts forming an intact monolayer. Infected cells on the image on the right display hantavirus-induced changes at their margins, with a discontinuous staining of ZO-1 and breakdown of the endothelial barrier function. Kidney International  , 23-27DOI: ( /ki ) Copyright © 2013 International Society of Nephrology Terms and Conditions


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