Understanding the Renal Fibrotic Process in Leptospirosis

Abstract

Leptospirosis is a neglected infectious disease caused by pathogenic species of the genus Leptospira. The acute disease is well-described, and, although it resembles other tropical diseases, it can be diagnosed through the use of serological and molecular methods. While the chronic renal disease, carrier state, and kidney fibrosis due to Leptospira infection in humans have been the subject of discussion by researchers, the mechanisms involved in these processes are still overlooked, and relatively little is known about the establishment and maintenance of the chronic status underlying this infectious disease. In this review, we highlight recent findings regarding the cellular communication pathways involved in the renal fibrotic process, as well as the relationship between renal fibrosis due to leptospirosis and CKD/CKDu.

Chronic kidney disease with unknown cause across the global spectrum

“…Hantavirus exposure has been observed in Sri Lanka but only recently in Central America, not correlating with CKDu incidence. Chronic leptospirosis can induce interstitial fibrosis and was identified serologically in sugarcane workers in Nicaragua, possibly exacerbating nephrotoxin-induced damage [48,49]. Regions of India had widespread leptospirosis before 2005 but this decreased coincidently with rising CKDu rates, making a causal association unlikely [36].…”