HEMODIAPERFUSION IN LEPTOSPIROSIS

Comparatively have been studied laboratory parameters in severe cases of leptospirosis divided in two groups – with and without hemodiaperfusion (HD). The dynamical investigations of blood urea nitrogen (BUN), serum creatinine, and serum bilirubin levels reveal that hemodiaperfusion markedly decreases the levels of nitrogen parameters and is non effective for serum bilirubin. Hemodiaperfusion in oliguric phase of the acute renal failure of leptospirosis prevents brain edema and lung edema significant tanatogenic factors.

AIM of this study is evaluation of effects of HD in severe cases of leptospirosis.

MATERIAL AND METHODS:
Clinical and laboratory parameters have been studied retrospectively and prospectively in 84 cases with leptospirosis treated in Clinic of Infectious Diseases -Pleven (1982 to 2004).

RESULTS AND DISCUSSION:
Using clinical and laboratory criteria characteristic for renal, hepatic, cardiovascular disorders and hemorrhagic syndrome has been evaluated the severity of the observed cases.Mild course (serum creatinine level below 200 µmol/L) in 52,38% of cases, moderate (serum creatinine level between 200 and 600 µmol/L) in 19,05%, and severe course (serum creatinine level above 600 µmol/L) in 28,57% have been established.The mortality is 14%.The illness is with acute onset with fever above 38 o C (100%), nausea with vomiting and diarrhea (86,90% and 21,43%, respectively), and oligoanuria (75%).
Dynamically are compared the followed laboratory parameters:

CONCLUSION:
HD in severe leptospirosis markedly decreases serum creatinine level and is not effective for serum bilirubin level.The early administration HD is especially benefit -reduces the risk for complications (brain edema and lung edema) and decreases mortality [1,5,7,8].

Table 1 .
BUN levels in group without and group with HD.

Table 3 .
Serum creatinine levels in group without and group with HD.

Table 4 .
Serum creatinine levels in survivors and fatal cases (compared averages between cases without and with HD).

Table 5 .
Serum bilirubin levels in group without and group with HD.

Table 6 .
Serum bilirubin levels in survivors and fatal cases (compared averages between cases without and with HD).