Leptospirosis-associated acute kidney injury in Odisha, India

Leptospirosis, a zoonotic disease, is a major cause of acute kidney injury (AKI) in tropical regions, with outbreaks frequently reported across India. Given the limited local literature, this study aimed to explore the incidence of leptospirosis-associated AKI (LAKI) in Odisha, an Eastern Indian state.

This hospital-based study was conducted from July 2020 to December 2022. Patients with acute febrile illness or a history of acute fever impacting normal kidney function who were admitted to two major tertiary care hospitals in Odisha were enrolled in this study. A pre-tested questionnaire gathered demographic and clinical data. Leptospirosis was detected using Lepto-IgM ELISA. Statistical analysis involved t-tests, chi-square tests, and one-way ANOVA, with significance set at p < 0.05 or p < 0.01.

Of the total 199 AKI patients included in the study, leptospirosis was confirmed in 57 (28.6%) cases, primarily affecting males (66.7%). The majority of LAKI patients were agricultural workers and resided in rural areas. Of the total LAKI patients, 8.8% had jaundice, and according to the KDIGO criteria, 77.2% were placed in stage 3 of AKI. The mortality rate was 15.8%. Statistically significant differences were observed in several laboratory parameters, including haemoglobin, platelet count, albumin, serum bilirubin, serum creatinine, serum urea nitrogen, serum alanine transaminase, and serum aspartate aminotransferase (all p < 0.00001).

The study found a high prevalence of LAKI, accompanied by a high case fatality rate. An extensive study is necessary to determine the exact burden of LAKI in Odisha to design an appropriate control strategy.