Going Micro in Leptospirosis Kidney Disease

Abstract

Leptospirosis is a zoonotic and waterborne disease worldwide. It is a neglected infectious disease caused by Leptospira spp., as well as a reemerging disease and global public health problem with respect to morbidity and mortality both in humans and animals. Leptospirosis emerges as a leading cause of acute febrile illness along with hepatorenal injury in many countries, including Thailand. While most affected persons are symptomatic in acute disease, which is always difficult to differentiate from other tropical diseases, there is growing evidence of subtle manifestations that cause unrecognized chronic symptoms. The kidney is one of the common organs affected by Leptospires. Although acute kidney injury in the spectrum of interstitial nephritis is a well-described characteristic in severe leptospirosis, chronic kidney disease from leptospirosis is widely discussed. Early recognition of severe leptospirosis leads to reduce morbidity and mortality. Thus, in this review, we highlight the spectrum of characteristics involved in leptospirosis kidney disease and the use of serologic and molecular methods, as well as the treatments of severe leptospirosis.

A rare case of Weil’s disease with acute pancreatitis and acute kidney injury: focus on management – a case report

“…Renal involvement is common in leptospirosis and its manifestations vary from mild proteinuria and changes in urine sediment to severe renal failure 13 . Two mechanisms have been suggested in the development of kidney failure in leptospirosis: direct nephrotoxic due to several endotoxins or endotoxin-like substances, and the anoxic effect due to kidney circulation disturbances 14 . There was no oliguria in this patient.…”

Narrative review of generalities of the genus Leptospira and its virulence factors associated with renal pathophysiology

“…26,[28][29][30][31] Leptospira OMPs produce renal tubular damage and inflammation through the toll-like innate immunity receptordependent pathway (TLR). 32 Leukocyte cells activate Nuclear transcription Factor-kappa B (NFKβ) and Mitogen-Activated Kinase Proteins (MAPK), synthesizing transcription factors for the synthesis and differential induction of chemokines and cytokines essential for tubular inflammation. [31][32][33] They can also activate the fibrosis pathway associated with the transforming growth factor-beta/Smad that accumulates on the extracellular matrix.…”

“…32 Leukocyte cells activate Nuclear transcription Factor-kappa B (NFKβ) and Mitogen-Activated Kinase Proteins (MAPK), synthesizing transcription factors for the synthesis and differential induction of chemokines and cytokines essential for tubular inflammation. [31][32][33] They can also activate the fibrosis pathway associated with the transforming growth factor-beta/Smad that accumulates on the extracellular matrix. 34 Renal leptospirosis disease is, therefore, a model to understand how pathogen-induced tubulointerstitial nephritis and fibrosis occur.…”

Ocular leptospirosis: lack of awareness among ophthalmologists and challenges in diagnosis

“…Occupational risks are associated with farming, mining, veterinary medicine, military, fieldwork, working at sugar cane plantations, sewage workers, slaughterhouse men, and miners. Outdoor recreational activities, including rafting, triathlons, canoeing, or bathing in contaminated natural water reservoirs are well-known risk factors in developed countries [16 ▪▪ ]. Epidemic outbreaks have been reported all over the world following floods [7 ▪ ,16 ▪▪ ,17].…”

“…Outdoor recreational activities, including rafting, triathlons, canoeing, or bathing in contaminated natural water reservoirs are well-known risk factors in developed countries [16 ▪▪ ]. Epidemic outbreaks have been reported all over the world following floods [7 ▪ ,16 ▪▪ ,17].…”