Elayaperumal Indhumathi (India)
Sri Ramachandra Institute of Higher Education and Research Department of NephrologyAuthor of 1 Presentation
RISK FACTORS AND PROGNOSTIC PREDICTORS OF ACUTE KIDNEY INJURY IN ADULT LEPTOSPIROSIS
Abstract
Background and Aims
Leptospirosis is the most important zoonosis in the world. Acute kidney injury is a prominent feature of leptospirosis.There is a broad spectrum of renal pathological changes.This study aimed to investigate the risk factors and prognostic predictors of Acute Kidney Injury in Leptospirosis.
Methods
This was a retrospective study done in a tertiary care center in Southern India. The medical records of all patients who were admitted and treated for leptospirosis infection from January 2015 to Novemeber 2020 were analyzed. Demographic, clinical and laboratory data were compared between the groups and analyzed. Multiple Logistic regression was performed to analyze the possible risk factors and predictors of prognosis associated with AKI in Leptospirosis.
Results
Among the 258 adults, 163(63.2%) were males and 95 (36.8%) were females. 222 (84%) patients were below the age of 65 years while only 36 (14%) patients were above the age of 65 years. Among these patients, 69 (26.7%) patients developed. Association between Leptospirosis associated AKI and various risk factors were analyzed using Pearson chi square test which showed significant association with diabetes (P- 0.002, OR-3.081), Hypertension (P-0.0003, OR-5.075). Patients with AKI were older in which 38.9% patients were in the >65 years group. Predictors for AKI were leukocytosis (P = 0.009, OR 2.109), Hyperbilirubinemia (P = 0.05, OR = 2.481).
Conclusions
Identification of features like daibetes, hypertension, leukocytosis, hyperbilirubinemia should alert the clinician on risk of developing AKI in leptospirosis. Prompt antibiotic treatment, adequate hemodynamic resuscitation, and early renal support are the key success in the treatment of leptospirosis-associated AKI.