Abstract

LEPTOSPIRAL-ACUTE KIDNEY INJURY; AN ALARMING PICTURE IN GENERAL PRACTICE: A SYSTEMATIC REVIEW

Tauqeer Hussain Mallhi*, Azmi Sarriff, Azreen Syazril Adnan, Yusra Habib Khan, Azhar Amir Hamzah, Fauziah Jummaat, Amer Hayat Khan

Abstract

Leptospirosis is most widespread zoonotic infection prevalent in hot and humid regions of the world. Severe form of disease is accompanied by several fatal complications. Kidney involvement is most dreaded complication of leptospirosis varies from urine sedimentations to severe acute kidney injury (AKI). Leptospiral AKI (LAKI) is most common and fatal intricacy of leptospirosis with incidence varying from 40-60% and a mortality rate of about 22%. LAKI leads to higher mortality rate and longer hospital stay as compared to those without acute kidney injury. Currently there is no such systemic review that describes association of acute kidney injury with leptospirosis and its impact on mortality and hospital stay. We systematically reviewed 35 research publications showing association of leptospirosis with acute kidney injury. Predictors of leptospiral acute kidney injury and mortality associated with leptospiral AKI were also observed. Most of the participants were male, rural residents and belong to leptospirosis risk groups. Mean hospital stay was 4-15 days and longer hospitalization was found in patients with severe form of acute kidney injury, multi organ failure and wrong diagnosis. Similarly mortality rate was around 19% which is also validated with previous findings. High mortality rate was found in severe acute kidney injury with multi organ failure. Other findings with LAKI were hypokalemia, oliguria and thrombocytopenia. Leptospirosis with acute kidney injury is severe form of disease that causes high mortality and increases hospitalization Moreover LAKI is also burdening overwhelmed health services so vigilant and proactive approach is needed to manage such patients for their better quality of life.

Keywords: Acute kidney injury, Leptospirosis, Weil`s Disease, Acute renal failure.