Kidney involvement in leptospirosis: a systematic review and meta-analysis.

IF 5.4 2区医学 Q1 INFECTIOUS DISEASES

Infection Pub Date : 2025-03-20 DOI:10.1007/s15010-025-02492-1

Astha Sethi, Tirlangi Praveen Kumar, Kutty Sharada Vinod, Carl Boodman, Rachana Bhat, Prithvishree Ravindra, Souvik Chaudhuri, Seema Shetty, V Shashidhar, Attur Ravindra Prabhu, Nitin Gupta

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引用次数: 0

Abstract

Introduction: From a public health perspective, it is essential to understand the burden of kidney involvement in leptospirosis. We aimed to assess the frequency of acute kidney injury (AKI) and chronic kidney disease (CKD) in patients with leptospirosis.

Methodology: This systematic review and meta-analysis included all articles up to 14.08.2024 from three databases (PubMed, Scopus, Web of Science) using search terms related to leptospirosis and kidney involvement. After de-duplication, two independent reviewers independently checked the articles in two phases (title-abstract and full-text), and a third reviewer adjudicated any conflicts. Patient demographics, diagnostic procedures, and details of kidney involvement were extracted from the included studies. Risk of bias analysis was done using the Joanna Briggs Institute critical appraisal tool. A random effects model estimated the pooled rates for AKI, oliguria, and the need for dialysis.

Results: Of the 5913 retrieved articles, 48 met the eligibility criteria. The pooled incidence of AKI, reduced urine output, and dialysis requirement was 49.2% (95%CI: 38.2-60.2%, I² of 99.4%), 31.5% (95%CI: 24.2-38.7%, I²-96.1%) and 14.4% (95%CI: 10.3-18.4%, I²-97%) respectively. The pooled mean serum creatinine and urea levels at admission were 3.6 mg/dl (95% CI: 2.9-4.2, I²-99.1%) and 131.8 mg/dl (95% CI: 98.7-164.9, I²-98.6%), respectively. In four studies, the incidence of new-onset CKD after leptospirosis infection varied from 13 to 62%.

Conclusion: AKI reduced urine output and the requirement for dialysis are frequent complications in patients with leptospirosis. Increased resources for their management in endemic areas are essential to mitigate the burden.

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钩端螺旋体病肾脏受累：一项系统回顾和荟萃分析。

从公共卫生的角度来看，了解钩端螺旋体病累及肾脏的负担是至关重要的。我们旨在评估钩端螺旋体病患者急性肾损伤（AKI）和慢性肾脏疾病（CKD）的频率。方法：本系统综述和荟萃分析纳入了截至2024年8月14日的所有文章，检索词为钩端螺旋体病和肾脏受累，检索词为PubMed、Scopus、Web of Science。重复删除后，两位独立审稿人分两个阶段（标题-摘要和全文）对文章进行独立检查，第三位审稿人对任何冲突进行裁决。从纳入的研究中提取了患者人口统计学、诊断程序和肾脏受累的细节。偏倚风险分析使用乔安娜布里格斯研究所的关键评估工具完成。随机效应模型估计AKI、少尿和透析需求的总发生率。结果：5913篇检索文章中，48篇符合入选标准。AKI、尿量减少和透析需求的总发生率分别为49.2% （95%CI: 38.2-60.2%, I2 = 99.4%）、31.5% （95%CI: 24.2-38.7%, I2-96.1%）和14.4% （95%CI: 10.3-18.4%, I2-97%）。入院时的合并平均血清肌酐和尿素水平分别为3.6 mg/dl （95% CI: 2.9-4.2, I2-99.1%）和131.8 mg/dl （95% CI: 98.7-164.9, I2-98.6%）。在四项研究中，钩端螺旋体病感染后新发CKD的发生率从13%到62%不等。结论：AKI减少尿量和透析需求是钩端螺旋体病患者常见的并发症。增加在流行地区进行管理的资源对于减轻负担至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Infection 医学-传染病学

CiteScore

12.50

自引率

1.30%

发文量

224

审稿时长

6-12 weeks

期刊介绍： Infection is a journal dedicated to serving as a global forum for the presentation and discussion of clinically relevant information on infectious diseases. Its primary goal is to engage readers and contributors from various regions around the world in the exchange of knowledge about the etiology, pathogenesis, diagnosis, and treatment of infectious diseases, both in outpatient and inpatient settings. The journal covers a wide range of topics, including: Etiology: The study of the causes of infectious diseases. Pathogenesis: The process by which an infectious agent causes disease. Diagnosis: The methods and techniques used to identify infectious diseases. Treatment: The medical interventions and strategies employed to treat infectious diseases. Public Health: Issues of local, regional, or international significance related to infectious diseases, including prevention, control, and management strategies. Hospital Epidemiology: The study of the spread of infectious diseases within healthcare settings and the measures to prevent nosocomial infections. In addition to these, Infection also includes a specialized "Images" section, which focuses on high-quality visual content, such as images, photographs, and microscopic slides, accompanied by brief abstracts. This section is designed to highlight the clinical and diagnostic value of visual aids in the field of infectious diseases, as many conditions present with characteristic clinical signs that can be diagnosed through inspection, and imaging and microscopy are crucial for accurate diagnosis. The journal's comprehensive approach ensures that it remains a valuable resource for healthcare professionals and researchers in the field of infectious diseases.