Renal Failure Due to Human Leptospirosis; An Overview

Leptospirosis is endemic in tropical and subtropical countries in South-East Asia. Patients are typically young and the disease influences a broad spectrum of mammals, and might lead to the wide variety conditions ranging from acute to chronic. One of the most important complications of leptospirosis is AKI. It is the most important zoonotic diseases caused by contact with either infected water or urine and can be transmitted to new hosts. Manifestation of leptospirosis varies from asymptomatic state in chronic form to symptomatic state, which encompasses fever, renal failure, icterus, and pulmonary hemorrhage in acute forms. Furthermore, AKI in leptospirosis, has many etiologies, and encompasses direct nephrotoxic action of the leptospira, hyperbillirubinemia, rhabdomyolysis, and hypervolemia (this means that this bacteria affects the tuft of the glumrol and also results in prerenal azotemia by the mechanism of hypovolemia). Case fatality rate of acute kidney injury due to leptospirosis is approximately 22%. This review is an attempt to summarize and discuss the current knowledge in the area of epidemiology and pathology of leptospirosis, with the latest therapeutic approach.