Seminars in Nephrology
Volume 28, Issue 4 , Pages 383-394 , July 2008

Leptospiral Nephropathy

  • Lúcia Andrade, MD, PhD

      Affiliations

    • Nephrology Department, University of São Paulo School of Medicine, São Paulo, Brazil.
    • Intensive Care Unit, Emílio Ribas Institute of Infectology, São Paulo, Brazil.
    • ,
  • Elizabeth de Francesco Daher, MD, PhD

      Affiliations

    • Department of Internal Medicine, Federal University of Ceará School of Medicine, Fortaleza, Brazil.
    • ,
  • Antonio Carlos Seguro, MD, PhD

      Affiliations

    • Nephrology Department, University of São Paulo School of Medicine, São Paulo, Brazil.
    • Intensive Care Unit, Emílio Ribas Institute of Infectology, São Paulo, Brazil.
    • Corresponding Author InformationAddress reprint requests to Antonio Carlos Seguro, Laboratório de Pesquisa Básica LIM-12, Faculdade de Medicina da USP, Av. Dr. Arnaldo 455, Sala 3310, CEP 01246-903, São Paulo, SP, Brazil.

References 

  1. McBride AJ, Athanazio DA, Reis MG, Ko AI. Leptospirosis. Curr Opin Infect Dis. 2005;18:376–386
  2. Bharti AR, Nally JE, Ricaldi JN, Matthias MA, Diaz MM, Lovett MA, et al. Leptospirosis: a zoonotic disease of global importance. Lancet Infect Dis. 2003;3:757–771
  3. Vinetz JM. Leptospirosis. Curr Opin Infect Dis. 2001;14:527–538
  4. Sambasiva RR, Naveen G, Bhalla P, Agarwal SK. Leptospirosis in India and the rest of the world. Braz J Infect Dis. 2003;7:178–193
  5. Levett PN. Leptospirosis. Clin Microbiol Rev. 2001;14:296–326
  6. Ko AI, Reis MG, Dourado CM, Johnson WD, Riley LW. Urban epidemic of severe leptospirosis in Brazil. Lancet. 1999;354:820–825
  7. Plank R, Dean D. Overview of the epidemiology, microbiology, and pathogenesis of Leptospira spp. in humans. Microb Infect. 2000;2:1265–1276
  8. Edwards CN, Nicholson GD, Hassel TA, Everard COR, Callender J. Leptospirosis in Barbados (A clinical study). West Indian Med J. 1990;39:27–34
  9. Costa E, Costa YA, Lopes AA, Sacramento E, Bina JC. Severe forms of leptospirosis: clinical, demographic and environmental aspects. Rev Soc Bras Med Trop. 2001;34:261–267
  10. Ko AI. Leptospirosis. In:  Goldman L,  Ausiello D editor. Cecil medicine. Philadelphia: Elsevier Saunders; 2008;p. 2296–2298
  11. De Brito T, Morais CF, Yasuda PH, Lancellotti CP, Hoshino-Shimizu S, Yamashiro E, et al. Cardiovascular involvement in human and experimental leptospirosis: pathologic finding and immunohistochemical detection for leptospiral antigen. Ann Trop Med Parasitol. 1987;81:207–214
  12. Nicodemo AC, Duarte MI, Alves VA, Takakura CH, Santos RT, Nicodemo EL. Lung lesions in human leptospirosis (Microscopic, immunohistochemical and ultrastructural features related to thrombocytopenia). Am J Trop Med Hyg. 1997;56:181–187
  13. Wagenar JF, Goris MG, Sakundarno MS, Gasem MH, Mairuhu AT, Kruif MD. What role do coagulation disorders play in the pathogenesis of leptospirosis?. Trop Med Int Health. 2007;12:111–122
  14. Daher EF, Zanetta DM, Cavalcante M, Abdulkader RC. Risk factors for death and changing patterns in acute renal failure of leptospirosis. Am J Trop Med Hyg. 1999;61:630–634
  15. Sitprija V, Losuwanrak K, Kanjanabuch T. Leptospiral nephropathy. Semin Nephrol. 2003;23:42–48
  16. Penna D, DeBrito T, Pupo AA, Machado MM, Galvão PAA, Soares SS. Kidney biopsy in human Leptospirosis. Am J Trop Med Hyg. 1963;12:896–901
  17. Sitprija V, Evans H. The kidney in human Leptospirosis. Am J Med. 1970;49:780–788
  18. Seguro AC, Lomar AV, Rocha AS. Acute renal failure of leptospirosis: non-oliguric and hypokalemic forms. Nephron. 1990;55:146–151
  19. Magaldi AJ, Yasuda PN, Kudo LH, Seguro AC, Rocha AS. Renal involvement in Leptospirosis: a pathophysiology study. Nephron. 1992;62:332–339
  20. Marotto PC, Nascimento CM, Eluf-Neto J, Marotto MS, Andrade L, Sztajnbok J, et al. Acute lung injury in Leptospirosis: clinical and laboratory features, outcome, and factors associated with mortality. Clin Infect Dis. 1999;29:1561–1563
  21. Andrade L, Rodrigues AC, Sanches TR, Souza RB, Seguro AC. Leptospirosis leads to dysregulation of sodium transporters in the kidney and lung. Am J Physiol Renal Physiol. 2007;292:586–592
  22. Khositseth S, Sudjaritjan N, Tananchai P, Ong-ajyuth S, Sitprija V, Thongboonkerd V. Renal magnesium wasting and tubular dysfunction in leptospirosis. Nephrol Dial Transplant. 2008;23:952–958
  23. Faria MT, Athanazio DA, Ramos EAG, Silva EF, Reis MG, Ko AI. Morphological alterations in the kidney of rats with natural and experimental Leptospira infection. J Comp Pathol. 2007;137:231–238
  24. El-Achkar TM, Huang X, Plotkin Z, Sandoval RM, Rhodes GJ, Dagher PC. Sepsis induces changes in the expression and distribution of Toll-like receptor 4 in the rat kidney. Am J Physiol Renal Physiol. 2006;290:F1034-F43
  25. Viriyakosol S, Matthias MA, Swancutt MA, Kirkland TN, Vinetz JM. Toll-like receptor 4 protects against lethal Leptospira interrogans serovar icterohaemorrhagiae infection and contributes to in vivo control of leptospiral burden. Infect Immun. 2006;74:887–895
  26. Yang CW, Wu MS, Pan MJ, Hsieh WJ, Vandewalle A, Huang CC. The Leptospira outer membrane protein LipL32 induces tubulointerstitial nephritis-mediated gene expression in mouse proximal tubule cells. J Am Soc Nephrol. 2002;13:2037–2045
  27. Daher EF, Zanetta DM, Abdulkader RC. Pattern of renal function recovery after leptospirosis acute renal failure. Nephron Clin Pract. 2004;98:8–14
  28. Marotto PC, Marotto MS, Santos DL, Souza TN, Seguro AC. Outcome of Leptospirosis in children. Am J Trop Med Hyg. 1997;56:307–310
  29. de Souza AL, Sztajnbok J, Marques SR, Seguro AC. Leptospirosis-induced meningitis and acute renal failure in a 19-month-old male child. J Med Microbiol. 2006;55:795–797
  30. Trevejo RT, Rigau-Pérez JG, Ashford DA, McClure EM, Jarquín-González C, Amador JJ, et al. Epidemic leptospirosis associated with pulmonary hemorrhage-Nicaragua, 1995. J Infect Dis. 1998;178:1457–1463
  31. Spichler A, Athanazio D, Buzzar M, Castro B, Chapolla E, Seguro A, et al. Using death certificate reports to find severe leptospirosis cases, Brazil. Emerg Infect Dis. 2007;13:1559–1561
  32. Dupont H, Dupont-Perdrizet D, Pierie JL, Zehner-Hansen S, Jarrige B, Daijardin JB. Leptospirosis: prognostic factors associated with mortality. Clin Infect Dis. 1997;25:720–724
  33. Spichler A, Ko AI, Silva EF, De Brito T, Silva AM, Athanazio D, et al. Reversal of renal tubule transporter downregulation during severe leptospirosis with antimicrobial therapy. Am J Trop Med Hyg. 2007;77:1111–1119
  34. Dolhnikoff M, Mauad T, Bethlem EP, Carvalho CR. Leptospiral pneumonias. Curr Opin Pulm Med. 2007;13:230–235
  35. Nally JE, Chantranuwat C, Wu XY, Fishbein MC, Pereira MM, Da Silva JJ, et al. Alveolar septal deposition of immunoglobulin and complement parallels pulmonary hemorrhage in a guinea pig model of severe pulmonary leptospirosis. Am J Pathol. 2004;164:1115–1127
  36. Shenoy VV, Nagar VS, Chowdhury AA, Bhalgat PS, Juvale NI. Pulmonary leptospirosis: an excellent response to bolus methylprednisolone. Post Grad Med J. 2006;82:602–606
  37. Matthay MA, Folkesson HG, Verkman AS. Salt and water transport across alveolar and distal airway epithelia in the adult lung. Am J Physiol. 1996;270:L487–L503
  38. Matthay MA, Folkesson HG, Clereci C. Lung epithelial fluid transport and the resolution of pulmonary edema. Physiol Rev. 2002;82:569–600
  39. Mehta R, Pascual M, Soroko S, Savage B, Himmelfarb J, Ikizler T, et al. Spectrum of acute renal failure in the intensive care unit: the PICARD experience. Kidney Int. 2004;66:1613–1621
  40. Andrade L, Cleto S, Seguro AC. Door-to-dialysis time and daily hemodialysis in patients with leptospirosis: impact on mortality. Clin J Am Soc Nephrol. 2007;2:739–744
  41. Ronco C, Bellomo R, Homel P, Brendolam A, Dan M, Piccinni P, et al. Effects of different doses in continuous veno-venous hemofiltration on outcome of acute renal failure: a prospective randomised trial. Lancet. 2000;356:26–30
  42. The National Heart Lung, and Blood Institute. Acute respiratory distress syndrome (ARDS) clinical trials network: comparison of two fluid-management strategies in acute lung injury. N Engl J Med. 2006;354:2564–2575
  43. Carvalho CR, Bethlem EP. Pulmonary complications of Leptospirosis. Clin Chest Med. 2002;23:469–478
  44. Amato MB, Carvalho CR. Severe acute respiratory distress syndrome, Leptospirosis, and lung protective strategies. Crit Care Med. 2006;34:2703–2704
  45. Pappas G, Cascio A. Optimal treatment of leptospirosis: queries and projections. Int J Antimicrob Agents. 2006;28:491–496
  46. Panaphut T, Domrongkitchaiporn S, Vibhagool A, Thinkamrop B, Susaengrat W. Ceftriaxone compared with sodium penicillin G for treatment of severe leptospirosis. Clin Infect Dis. 2003;36:1507–1513
  47. Ghouse M, Maulana AB, Mohamed Ali MG, Sarasa VD. A two year study of the efficacy of azithromycin in the treatment of leptospirosis in human. Indian J Med Microbiol. 2006;24:345–346
  48. Phimda K, Hoontrakul S, Suttinont C, Chareonwat S, Losuwanaluk K, Chueasuwanchai S, et al. Doxycycline versus azithromycin for treatment of leptospirosis and scrub typhus. Antimicrob Agents Chemother. 2007;51:3259–3263
  49. Suputtamongkol Y, Niwattayakul K, Suttinont C, Losuwanaluk K, Limpaiboon R, Chierakul W, et al. An open, randomized, controlled trial of penicillin, doxycycline, and cefotaxime for patients with severe leptospirosis. Clin Infect Dis. 2004;39:1417–1424
  50. Sehgal SC, Sugunan AP, Murhekar , Sharma S, Vijayachari P. Randomized controlled trial of doxycycline prophylaxis against leptospirosis in an endemic area. Int J Antimicrob Agents. 2000;13:249–255
  51. Ren SX, Fu G, Jiang XG, Zeng R, Miao YG, Xu H, et al. Unique physiological and pathogenic features of Leptospira interrogans revealed by whole-genome sequencing. Nature. 2003;422:888–893
  52. Nascimento AL, Ko AI, Martins EA, Monteiro-Vitorello CB, Ho PL, Haake DA, et al. Comparative genomics of two Leptospira interrogans serovars reveals novel insights into physiology and pathogenesis. J Bacteriol. 2004;186:2164–2172
  53. Fournier PE, Drancourt M, Raoult D. Bacterial genome sequencing and its use in infectious disease. Lancet Infect Dis. 2007;7:711–723
  54. Neves FO, Abreu PA, Vasconcellos SA, de Morais ZM, Romero EC, Nascimento AL. Identification of a novel potential antigen for early diagnosis of leptospirosis. Arch Microbiol. 2007;188:523–532

 Supported in part by a grant from the Fundação de Amparo à Pesquisa do Estado de São Paulo (Foundation for the Support of Research in the State of São Paulo). A.C.S. is the recipient of a grant (309430/2006-7) from the Conselho Nacional de Desenvolvimento Científico e Tecnológico (National Council for Scientific and Technological Development).

PII: S0270-9295(08)00086-7

doi: 10.1016/j.semnephrol.2008.04.008

Seminars in Nephrology
Volume 28, Issue 4 , Pages 383-394 , July 2008

Article Tools

* Image Usage & Resolution