Renal Failure and Hyperbilirubinæmia in Leptospirosis Treatment With Exchange Transfusion

Sitprija,; Chusilp, Sinobol

doi:10.5694/j.1326-5377.1973.tb119700.x

Cited by 12 publications

(5 citation statements)

References 8 publications

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“…The present study showed an improvement of systemic haemodynamics in leptospirosis by plasmapheresis, as well as CVVH. Blood exchange has been shown to improve renal function in a leptospirosis patient with hyperbilirubinaemic renal failure 29,30 . In previous studies, in patients with sepsis, improvement of haemodynamics following CVVH was associated with the decrease in plasma TNF‐α 31–33 .…”

Section: Discussionmentioning

confidence: 95%

Haemodynamics in leptospirosis: Effects of plasmapheresis and continuous venovenous haemofiltration

et al. 2005

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All patients had pulmonary complications with a chest X-ray showing either pulmonary oedema or infiltration. Renal failure was present in nine patients. Three patterns of haemodynamics were revealed. The first pattern was observed in six patients who showed increased cardiac index, decreased systemic vascular resistance, normal pulmonary capillary wedge pressure, normal pulmonary vascular resistance and hypotension. The pattern resembled that of sepsis. The second pattern shown in two patients with haemoptysis consisted of a normal cardiac index, normal systemic vascular resistance, normal blood pressure, normal pulmonary capillary wedge pressure and increased pulmonary vascular resistance. The third pattern was observed in two patients with severe jaundice who had hypotension, a relatively low cardiac index, increased systemic vascular resistance and normal pulmonary capillary wedge pressure, and pulmonary vascular resistance. Plasmapheresis performed in two patients and continuous venovenous haemofiltration performed in two patients improved systemic haemodynamics and normalized blood pressure with a resolution of lung signs.

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Section: Discussionmentioning

confidence: 95%

Haemodynamics in leptospirosis: Effects of plasmapheresis and continuous venovenous haemofiltration

et al. 2005

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“…Based on the principle of removing bacterial products, cytokines, chemokines, mediators, bilirubin and bile acids blood exchange can be performed at a less cost. [20,21] The previous study has shown improvement of systemic and renal hemodynamics by blood exchange. In severe leptospirosis plasmapheresis increased the cardiac output and improved the renal blood flow and the glomerular filtration rate.…”

Section: Discussionmentioning

confidence: 99%

Hypotension, Renal Failure, and Pulmonary Complications in Leptospirosis

et al. 2002

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During a recent outbreak of leptospirosis in northeastern Thailand, 148 patients with serologically diagnosed leptospirosis were seen in Loei hospital. The common serotypes were L. pyrogenes, and L. sejroe. Hypotension with a mean arterial pressure less than 70 mmHg upon admission or within 24 h after admission was observed in 94 patients or 64%. 30 patients had normal renal function; 30 patients had prerenal azotemia with mild pulmonary complication in 2; and 34 patients had acute renal failure. 29 patients with acute renal failure had pulmonary complications including pulmonary hemorrhage in 8, pulmonary edema in 3, acute respiratory distress syndrome (ARDS) in 14 and interstitial pneumonitis in 4. 54 patients had normal blood pressure. In this group 5 patients had acute renal failure; 16 had prerenal azotemia and 33 had normal renal function. Interstitial pneumonitis was noted in one patient with prerenal azotemia. Less renal complication and minimal pulmonary complication were seen in leptospirosis patients with normal blood pressure. The patients with normal renal function had no pulmonary complication. Good association existed between hypotension, renal failure and pulmonary complications.

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“…[37][38][39] High levels of bilirubin can induce natriuresis and harms kidneys if TB levels are > 20 mg/dL. [37][38][39] Thus, the removal of these toxic substance of hyperbilirubinemia by plasma exchange or dialysis can be useful for both hepatocyte and renal tubular cell function and was associated with survival improvement in a previous study. 40 Although the cornerstone of treatment of malarial-infected patients is still antimalarial drugs, there is a need for adjuvant therapy of targeting toxin removal in order to decrease the significant mortality associated with malaria and jaundice.…”

Section: Discussionmentioning

confidence: 97%

“…A previous study showed that the free oxygen radicals produced in cholestatic jaundice can play an important role in renal tubular cell injury 37–39 . High levels of bilirubin can induce natriuresis and harms kidneys if TB levels are > 20 mg/dL 37–39 . Thus, the removal of these toxic substance of hyperbilirubinemia by plasma exchange or dialysis can be useful for both hepatocyte and renal tubular cell function and was associated with survival improvement in a previous study 40 .…”

Section: Discussionmentioning

confidence: 98%

“…In patients with severe PF malarial infection, the components of reduced blood volume and impaired renal hemodynamics mainly have an effect on the renal blood flow and glomerular filtration rate, leading to ARF 36 . A previous study showed that the free oxygen radicals produced in cholestatic jaundice can play an important role in renal tubular cell injury 37–39 . High levels of bilirubin can induce natriuresis and harms kidneys if TB levels are > 20 mg/dL 37–39 .…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Ursodeoxycholic acid and artesunate in the treatment of severe falciparum malaria patients with jaundice

Treeprasertsuk

Silachamroon

Krudsood

et al. 2010

J of Gastro and Hepatol

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Renal Failure and Hyperbilirubinæmia in Leptospirosis Treatment With Exchange Transfusion

Cited by 12 publications

References 8 publications

Haemodynamics in leptospirosis: Effects of plasmapheresis and continuous venovenous haemofiltration

Haemodynamics in leptospirosis: Effects of plasmapheresis and continuous venovenous haemofiltration

Hypotension, Renal Failure, and Pulmonary Complications in Leptospirosis

Ursodeoxycholic acid and artesunate in the treatment of severe falciparum malaria patients with jaundice

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