1. Long-term Effects of Leptospirosis
Long-term Effects of Leptospirosis on the Kidney ST De Silva1, N J A H D Perera1, M Bailey2, H J De Silva1 1Department of Medicine, University of Kelaniya, 2Royal Centre for Defense Medicine, UK
OBJECTIVES
Leptospirosis is an important seasonal disease in Sri Lanka. Renal involvement is a prominent feature in most cases. Although much is known about the pathogenesis and outcome of acute renal impairment, information concerning Leptospirosis-induced chronic kidney disease is scarce, with only one case report documented worldwide.
We aimed to determine whether chronic kidney disease occurs as a sequelae of Leptospirosis, by doing a follow up study of patients with proven Leptospirosis 2 years after the illness.
METHODS
All admissions to the Professorial Medical Unit, Teaching Hospital, Ragama during with Leptospirosis infection (proven by DNA testing) were re-assessed, using a questionnaire, blood pressure check, urinanalysis and serum creatinine measurement.
RESULTS
25/38 patients (65.8%) reported for re-assessment. Mean age of the study group was years (range years). 23/25 were males. 16/25 patients (64%) had some degree of renal impairment during the acute illness.
At follow up, mean duration since the acute illness was days (range days). Serum creatinine and calculated creatinine clearance (MDRD) was within the normal range for all patients. None had an active urinary sediment.
CONCLUSIONS
Leptospirosis does not appear to cause chronic renal impairment. Treating Leptospirosis-induced acute renal impairment aggressively is fully justified since long term renal outcome is excellent.
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