RENAL INVOLVEMENT IN HUMAN LEPTOSPIROSIS

Renal function was studied in 10 azotaemic patients with proved leptospirosis. In five patients azotaemia was ascribed to parenchymal renal failure of acute tubular necrosis. In this group the serum creatinine was higher than 2 mg./100 mi. and the osmotic urine and plasma ratio averaged 1.24, indicating a defect in renal concentration. In another group of five patients the renal function study suggested that volume deficit or dehydration might be the cause of azotaemia. The serum creatinine was lower than 2 mg./100 ml. and the mean osmotic urine and plasma ratio was 2.35. In both groups there was a decrease in endogenous creatinine and para-aminohippurate clearances ; the decrease was more pronounced in group 1. Because of the clinical inaccuracy in detecting dehydration the serum creatinine and the osmotic urine and plasma ratio may be used as a clue in ascertaining the cause of azotaemia, and thus provide useful information regarding the fluid therapy of azotaemic patients with leptospirosis. © 1968, British Medical Journal Publishing Group. All rights reserved.