1921
Volume 85, Issue 3
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Abstract.

The aim of this study is to investigate the changes in clinical pattern and therapeutic measures in leptospirosis-associated acute kidney injury; a retrospective study with 318 patients in Brazil. Patients were divided according to the time of admission: 1985–1996 (group I) and 1997–2010 (group II). Patients were younger in group I (36 ± 13 versus 41 ± 16 years, = 0.005) and the numbers of oliguria increased (21% versus 41% in group II, = 0.014). Higher frequency of lung manifestations was observed in group II ( < 0.0001). Although increased severity, there was a significant reduction in mortality (20% in group I versus 12% in group II, = 0.03). Mortality was associated with advanced age, low diastolic blood pressure, oliguria, arrhythmia, and peritoneal dialysis, besides a trend to better mortality with penicillin administration. Leptospirosis is occurring in an older population, with a higher number of oliguria and lung manifestations. However, mortality is decreasing and can be the result of changes in treatment.

Loading

Article metrics loading...

The graphs shown below represent data from March 2017
/content/journals/10.4269/ajtmh.2011.11-0080
2011-09-01
2019-03-21
Loading full text...

Full text loading...

/deliver/fulltext/14761645/85/3/479.html?itemId=/content/journals/10.4269/ajtmh.2011.11-0080&mimeType=html&fmt=ahah

References

  1. Adler B, de la Peña Moctezuma A, , 2010. Leptospira and leptospirosis. Vet Microbiol 140: 287296.[Crossref] [Google Scholar]
  2. Victoriano AF, Smythe LD, Gloriani-Barzaga N, Cavomta LL, Kasai T, Limpakarnjanarat K, Ong BL, Gongal G, Hall J, Coulcombe CA, Yanagihara Y, Yoshida S, Adler B, , 2009. Leptospirosis in the Asia Pacific region 2009. BMC Infect Dis 9: 147.[Crossref] [Google Scholar]
  3. Bharti AR, Nally JE, Ricaldi JN, Matthias MA, Diaz MM, Lovett MA, Gilman RH, Willig MR, Gotuzzo E, Vinetz JM, , Reru-United States Leptospirosis Consortium, 2003. Leptospirosis: a zoonotic disease of global importance. Lancet Infect Dis 3: 757771.[Crossref] [Google Scholar]
  4. Yanagihara Y, Villanueva SY, Yoshida S, Okamoto Y, Masuzawa T, , 2007. Current status of leptospirosis in Japan and Philippines. Comp Immunol Microbiol Infect Dis 30: 399413.[Crossref] [Google Scholar]
  5. Vinetz JM, Glass GE, Flexner CE, Mueller P, Kaslow DC, , 1996. Sporadic urban leptospirosis. Ann Intern Med 125: 794798.[Crossref] [Google Scholar]
  6. Sejvar J, Tangkanakul W, Ratanasang P, Dowell SF, Sangjun N, Bragg S, Ashford D, Tappero J, , 2005. An outbreak of leptospirosis, Thailand–the importance of the laboratory. Southeast Asian J Trop Med Pub Hlth 36: 289295. [Google Scholar]
  7. Levett PN, , 2001. Leptospirosis. Clin Microbiol Rev 14: 296326.[Crossref] [Google Scholar]
  8. Andrade L, Daher EF, Seguro AC, , 2008. Leptospiral nephropathy. Semin Nephrol 28: 383394.[Crossref] [Google Scholar]
  9. Daher EF, Silva Junior GB, Karbage NN, Carvalho PC, Jr Kataoka RS, Silva EC, Magalhães MM, Avaújo SM, Gutiérrez-Adruabzén OA, Libório AB, , 2009. Predictors of oliguric acute kidney injury in leptospirosis: a retrospective study on 196 consecutive patients. Nephron Clin Pract 112: c25c30.[Crossref] [Google Scholar]
  10. Roca B, , 2006. Leptospirosis. Rev Med Univ Navarra 50: 36. [Google Scholar]
  11. Ko AI, Galvao RM, Ribeiro DC, Johnson WD, Jr Riley LW, , 1999. Urban epidemic of severe leptospirosis in Brazil. Salvador Leptospirosis Study Group. Lancet 354: 820825.[Crossref] [Google Scholar]
  12. Andrade L, Cleto S, Seguro AC, , 2007. Door-to-dialysis time and daily hemodialysis in patients with leptospirosis: impact on mortality. Clin J Am Soc Nephrol 2: 739744.[Crossref] [Google Scholar]
  13. Daher EF, Zanetta DM, Cavalcante MB, Abdulkader RC, , 1999. Risk factors for death and changing patterns in leptospirosis acute renal failure. Am J Trop Med Hyg 61: 630634. [Google Scholar]
  14. Bellomo R, Kellum JA, Ronco C, , 2007. Defining and classifying acute renal failure: from advocacy to consensus and validation of the RIFLE criteria. Intensive Care Med 33: 409413.[Crossref] [Google Scholar]
  15. Ko AI, Galvao RM, Ribeiro DC, Johnson WD, Jr Riley LW, , 1999. Urban epidemic of severe leptospirosis in Brazil. Salvador Leptospirosis Study Group. Lancet 354: 820825.[Crossref] [Google Scholar]
  16. Esen S, Sunbul M, Leblebicioglu H, Eroglu C, Turan D, , 2004. Impact of clinical and laboratory findings on prognosis in leptospirosis. Swiss Med Wkly 134: 347352. [Google Scholar]
  17. World Health Organization, 2003. What are the main risk factors for disability at old age and how can disability be prevented? Europe: Regional Office for Europe's Health Evidence Network (HEN). [Google Scholar]
  18. U.S. Census Bureau, 2010. Projections of the Population by Selected Age Groups and Sex for the United States: 2010 to 2050. Available at: http://www.census.gov/population/www/projections/summarytables.html. Accessed May 14, 2010. [Google Scholar]
  19. Minisério da Saúde do Brasil = Brazilian Ministry of Health, 2010. Leptospirose – Casos confirmados notificados no Sistema de Informação de Agravos de Notificação – Sinan. Leptospirosis – Confirmed cases, registered by the Notifiable Diseases System – Sinan. Available at: http://dtr2004.saude.gov.br/sinanweb/tabnet/dh?sinan/lepto/bases/leptobr.def. Accessed June 6, 2010. [Google Scholar]
  20. Abdulkader RC, Daher EF, Camargo ED, Spinosa C, Silva MV, , 2002. Leptospirosis severity may be associated with the intensity of humoral immune response. Rev Inst Med Trop Sao Paulo 44: 7983.[Crossref] [Google Scholar]
  21. Daher EF, Marques CN, Lima RS, Silva Júnior GB, Barbosa AS, Barbosa ES, Mota RM, Leite da Silva S, Araújo SM, Libório AB, , 2008. Acute kidney injury in an infectious disease intensive care unit – an assessment of prognostic factors. Swiss Med Wkly 138: 128133. [Google Scholar]
  22. Spichler AS, Vilaça PJ, Athanazio DA, Albuquerque JO, Buzzar M, Catro B, Seguro A, Vinetz JM, , 2008. Predictors of lethality in severe leptospirosis in urban Brazil. Am J Trop Med Hyg 79: 911914. [Google Scholar]
  23. Dupont H, Dupont-Perdrizet D, Perie JL, Zehner-Hansen S, Jarrige B, Daijardin JB, , 1997. Leptospirosis: prognostic factors associated with mortality. Clin Infect Dis 25: 720724.[Crossref] [Google Scholar]
  24. Sacramento E, Lopes AA, Costa E, Passos OL, Costa YA, Matos ED, , 2002. Electrocardiographic alterations in patients hospitalized with leptospirosis in the Brazilian city of Salvador. Arq Bras Cardiol 78: 267270.[Crossref] [Google Scholar]
  25. Siriwanij T, Suttinont C, Tantawichien T, Chusil S, Kanjanabuch T, Sitprija V, , 2005. Haemodynamics in leptospirosis: effects of plasmapheresis and continuous venovenous hemofiltration. Nephrology (Carlton) 10: 16.[Crossref] [Google Scholar]
  26. Prowle JR, Echeverri JE, Ligabo EV, Ronco C, Bellomo R, , 2010. Fluid balance and acute kidney injury. Nat Rev Nephrol 6: 107115.[Crossref] [Google Scholar]
  27. Michalopoulos A, Pappas G, Papadakis E, Chirtoforatos T, Malamos P, Koumoudiou C, Chalevelakis G, , 2010. Leptospirosis in a European intensive care unit. Scand J Infect Dis 42: 6971.[Crossref] [Google Scholar]
  28. Shah I, , 2009. Non-oliguric renal failure – a presentation of leptospirosis. Ann Trop Med Parasitol 103: 5356.[Crossref] [Google Scholar]
  29. Joannidis M, Druml W, Forni LG, Groeneveld AB, Honore P, Oudemans-van Straaten HM, Ronco C, Schetz MR, Woittiez AJ, , 2010. Prevention of acute kidney injury and protection of renal function in the intensive care unit. Expert opinion of the Working Group for Nephrology. Intensive Care Med 36: 392411.[Crossref] [Google Scholar]
http://instance.metastore.ingenta.com/content/journals/10.4269/ajtmh.2011.11-0080
Loading
/content/journals/10.4269/ajtmh.2011.11-0080
Loading

Data & Media loading...

  • Received : 07 Feb 2011
  • Accepted : 16 Jun 2011

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error