Rcrm. Abdulkader et al., PECULIAR ELECTROLYTIC AND HORMONAL ABNORMALITIES IN ACUTE-RENAL-FAILURE DUE TO LEPTOSPIROSIS, The American journal of tropical medicine and hygiene, 54(1), 1996, pp. 1-6
Citations number
26
Categorie Soggetti
Public, Environmental & Occupation Heath","Tropical Medicine
Hypokalemia in leptospirosis acute renal failure (ARF) was studied in
nine patients with severe leptospirosis ARF and five patients with mod
erate leptospirosis ARF and compared with five patients with severe ac
ute tubular necrosis (ATN) and eight healthy individuals. Urinary volu
mes of both the severe and moderate leptospirosis groups were higher t
han those of the severe ATN group. Leptospirosis groups had serum pota
ssium levels lower than those found in the healthy and severe ATN grou
ps. Serum sodium levels were lower in the severe leptospirosis group t
han in the moderate leptospirosis, the severe ATN, and the healthy gro
ups. There was a positive correlation between the fractional excretion
of sodium and potassium in the severe leptospirosis group as well as
between serum creatinine and potassium levels in the pooled leptospiro
sis groups. Urinary pH in the severe and moderate leptospirosis groups
was lower than in the severe ATN group. Aldosterone levels were highe
r in the severe leptospirosis group than in the healthy individuals. C
ortisol levels were higher in the leptospirosis groups than in the hea
lthy subjects. These results strongly suggest that hypokalemia in lept
ospirosis ARF is due to renal potassium wasting potentialized by aldos
terone and cortisol, requiring that special attention is given to pota
ssium replacement as well as to volume repletion in the treatment of l
eptospirosis ARF.