Study site and population
The study was conducted at the Singapore General Hospital (SGH). SGH is the country's oldest and largest tertiary hospital and national referral center with 1521 acute-care beds. Admission criteria for suspected dengue is presence of one or more of the following: significant bleeding, severe vomiting or diarrhea that requires intravenous infusion, blood pressure < 90/60 mm Hg and/or pulse rate > 100 beats/minute, severe abdominal pain, dehydration with electrolyte abnormalities and/or postural hypotension, are elderly with medical co-morbidities and are unwell, hematocrit > 50% or platelet count < 80,000 cells/mm3[7]. Adult patients are admitted and managed according to WHO guidelines [8]. The following working day, the patients are transferred to the Department of Family Medicine and Continuing Care, where they were prospectively enrolled into the study. Exclusion criteria were, negative confirmatory test for dengue, failure to follow study protocol and preexisting renal disease