Acute kidney injury in leptospirosis: A country-level report

• Published in: Travel medicine and infectious disease 2022-09, Vol.49, p.102359-102359, Article 102359
• Main Authors: Rista, Elvana, Puca, Edmond, Cadri, Vilma, Saliaj, Kristi, Akshija, Ilir, Duraku, Ahmet, Bino, Silvia, Abazaj, Erjona, Alla, Luljeta, Harxhi, Arjan
• Format: Article
• Language: English
• Subjects: Antibiotics; Anuria; Classification; Creatinine; Disease; Electrolytes; Hospitals; Hyponatremia; Infections; Infectious diseases; Kidneys; Laboratories; Length of stay; Leptospirosis; Males; Mortality; Patients; Renal replacement therapy; Serum; Statistical analysis; Statistical methods; Teresa (Mother); Travel medicine; Urine
• ISSN: 1477-8939; 1873-0442
• DOI: 10.1016/j.tmaid.2022.102359

Timely implementation of supportive measures along with early administration of antibiotic therapy, have been shown to significantly improve outcomes and reduce morbidity and mortality rates [1,2,4,5,18,45–50].1.1 Study design We conducted a prospective, observational, monocentric study in the span of five years, from 2010 to 2015.119 consecutive patients admitted to the Department of Nephrology and Hemodialysis and the Department of Infectious Diseases at University Hospital Center “Mother Teresa” Tirana, Albania, during this five-year period, were identified and enrolled. The severity of the acute kidney injury was delineated according to the RIFLE: risk (R), injury (I), failure (F), loss (L), end-stage kidney disease (E) and Acute Kidney Injury Network (AKIN): AKIN I, AKIN II, AKIN III classifications, with patients being categorized correspondingly.1.2 Statistical analysis Descriptive statistical analysis was carried out using IBM SPSS Statistics Version 26, and MedCalc Statistical Software 14.8.1. Based on the RIFLE classification, severe AKI conformed to the Failure stage, defined as an increase in serum creatinine to 3 times baseline, or an increase in serum creatinine by > 0.5 mg/dL to >4.0 mg/dL, or an urine output of 24 h or anuria for >12 h, or the initiation of kidney replacement therapy.2 Results Between 2010 and 2015, a total of 119 patients were admitted with a diagnosis of Leptospirosis at University Hospital Center “Mother Teresa”, the only tertiary-level hospital in the country, offering specialized care for patients presenting with complications. All patients in the deceased group were males and manifested oliguric-AKI (stage-F and stage-III, according to the RIFLE and AKIN criteria, respectively), as well as hematuria throughout the course of the disease. 8 patients manifested albuminuria and 6 of them underwent renal replacement therapy (Fig. 3).2.1 Severe and non-severe AKI, according to RIFLE and AKIN classification Significant differences in specific laboratory data including hyponatremia, bilirubin levels, hyperkalemia, length of hospital stay and urinary output emerged, when comparing patients with severe and non-severe AKI.