back to 2012, vol. 18, b. 3

Journal of IMAB - Annual Proceeding (Scientific Papers)
Publisher: Peytchinski, Gospodin Iliev
ISSN: 1312 773X (Online)
Issue: 2012, vol. 18, book 3;
Subject Collection: Medicine
Page: 265 - 269
DOI: 10.5272/jimab.2012183.265
Published online: 11 July 2012

J of IMAB. 2012; 18(3):265-269
Galya I. Gancheva
Department of Infectious Diseases, Epidemiology, Parasitology and Tropical Medicine,
Medical University - Pleven, Bulgaria.

Renal involvement is a common feature of leptospirosis. It is variable from mild to severe acute renal failure. Materials and methods: We performed analysis of 100 consecutive leptospirosis cases treated in Clinic of Infectious Diseases at University Hospital – Pleven (1976-2012) (90 male, age 37±18 years, lethal outcome in 13%), followed by comparative analysis of group with renal involvement (n1=59) versus group without renal involvement (controls: n2=41). Results: Fever (100%), hepatomegaly (92%), myalgia (86%), nausea and vomiting (84%), splenomegaly (74%), oliguria (69%), headache (67%), jaundice (63%), hypotension (49%), abdominal pain (41%), and hemorrhagic diathesis (37%) were the characteristic manifestations and had had a significantly higher prevalence in the group with renal involvement. Blood urea nitrogen (mean 27.9±16.9 mmol/L) and serum creatinine (mean 349.9±190.1 µmol/L) were the main laboratory parameters that expressed renal dysfunction in this group. Dialysis was performed in twelve severe cases. Conclusion: Leptospirosis with acute renal failure is a severe disease and requires early diagnosis and prompt treatment.

Key words: acute renal failure; hepatic dysfunction; leptospirosis; renal involvement.

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Please cite this article as: Gancheva GI. RENAL INVOLVEMENT IN LEPTOSPIROSIS. J of IMAB. 2012; 18(3):265-269. doi: 10.5272/jimab.2012183.265

1. Ko AI, Galvão Reis M, Ribeiro Dourado CM, Johnson WD Jr, Riley LW. Urban epidemic of severe leptospirosis in Brazil. Salvador leptospirosis Study group. Lancet. 1999 Sep;354(9181):820–825. [PubMed]
2. Daher E, Zanetta DM, Cavalcante MB, Abdulkader RC. Risk factors for death and changing patterns in leptospirosis acute renal failure. Am J Trop Med Hyg. 1999 Oct;61(4):630–634. [PubMed]
3. Covic A, David J. A. Goldsmith DJA, Gusbeth-Tatomir P, Seica A, Covic M. A retrospective 5-year study in Moldova of acute renal failure due to leptospirosis: 58 cases and a review of the literature. Nephrol Dial Transplant. 2003 Jun;18(6):1128–1134. [PubMed] [CrossRef]
4. Levett PN. Leptospirosis. Clin Microbiol Rev 2001 Apr;14(2):296-326. [PubMed] [CrossRef]
5. Sitprija V, Losuwanrak K, Kanjanabuch T. Leptospiral nephropathy. Semin Nephrol. 2003 Jan;23(1): 42-48. [PubMed]
6. Ashford DA, Kaiser RM, Spiegel RA, Perkins BA, Weyant RS, Bragg SL, et al. Asymptomatic infection and risk factors for leptospirosis in Nicaragua. Am JTrop Med Hyg. 2000 Nov-Dec;63(5-6):249–254. [PubMed]
7. Yang CW, Wu MS, Pan MJ. Leptospirosis renal disease. Nephrol Dial Transplant 2001; 16(Suppl 5): 73-77. [PubMed] [CrossRef]
8. Katz AR, Ansdell VE, Effler PV, Middleton CR, Sasaki DM. Assessment of the clinical presentation and treatment of 353 laboratory-confirmed leptospirosis in Hawaii, 1974–1998. ClinInfect Dis. 2001 Dec 1; 33(11): 1834–1841. [PubMed] [CrossRef]
9. Spichler AS, Vilaça PJ, Athanazio DA, Albuquerque JOM, Buzzar M, Castro B, et al. Predictors of Lethality in Severe Leptospirosis in Urban Brazil. Am J Trop Med Hyg. 2008 Dec;79(6):911–914. [PubMed]
10. Gancheva G. Complex researches at leptospirosis. PhD dissertation, MU – Pleven, Bulgaria,2006. [in Bulgarian]
11. Vinh T, Faine S, Handley CJ, Adler B. Immunohistochemical studies of opsonic epitopes of the lipopolysaccharide of Leptospira interrogans serovar hardjo. FEMS Immunol Med Microbiol. 1994 Feb; 8(2): 99-103. [PubMed] [CrossRef]
12. Younes-Ibrahim M, Burth P, Faria MV, Buffin-Meyer B, Marsy S, Barlet-Bas C, et al. Inhibition of Na, K-ATPase by an endotoxin extracted from Leptospira interrogans: a possible mechanism for the physiopathology of leptospirosis. C R Acad Sci III. 1994 May;318(5):619–625. [PubMed].

Accepted for publication: 08 May 2012
Issue published online: 11 July 2012

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