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Kidney involvement in leptospirosis: a systematic review and meta-analysis
Astha Sethi1, Tirlangi Praveen Kumar1, Kutty Sharada Vinod2
1Department of Infectious Diseases, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, 576104, India.
Infection
|March 20, 2025
Summary
Kidney injury is a common complication of leptospirosis, affecting nearly half of patients. This systematic review highlights the significant burden of acute kidney injury (AKI) and the need for better management strategies in endemic regions.
Area of Science:
- Infectious Diseases
- Nephrology
- Public Health
Background:
- Leptospirosis poses a significant public health challenge, with kidney involvement being a critical concern.
- Understanding the prevalence of kidney disease in leptospirosis patients is crucial for effective management and resource allocation.
Purpose of the Study:
- To systematically review and meta-analyze the frequency of acute kidney injury (AKI) and chronic kidney disease (CKD) in patients diagnosed with leptospirosis.
- To quantify the pooled incidence of AKI, oliguria, and the need for dialysis in leptospirosis cases.
Main Methods:
- A comprehensive systematic review and meta-analysis of studies published up to August 14, 2024, utilizing PubMed, Scopus, and Web of Science.
- Inclusion criteria involved studies on leptospirosis and kidney involvement; data extraction and risk of bias assessment were performed by independent reviewers.
- Pooled rates for AKI, oliguria, and dialysis were estimated using a random effects model.
Main Results:
- The pooled incidence of AKI was 49.2%, reduced urine output was 31.5%, and dialysis requirement was 14.4% among leptospirosis patients.
- Elevated serum creatinine (3.6 mg/dl) and urea (131.8 mg/dl) levels were observed upon admission.
- The incidence of new-onset CKD post-infection ranged widely from 13% to 62% across four studies.
Conclusions:
- Acute kidney injury, oliguria, and the need for dialysis are highly prevalent complications of leptospirosis.
- There is a substantial burden of kidney disease associated with leptospirosis, necessitating increased healthcare resources in endemic areas for improved patient outcomes.
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