Risk factors for death and changing patterns in leptospirosis acute renal failure

The risk factors for death and changes in clinical patterns in leptospirosi s (Weil's disease) have not been well studied. We retrospectively studied 1 10 patients with Weil's disease hospitalized in Brazil between 1985 and 199 6. Univariate statistical analysis showed that nonsurvivors were older than survivors, and had higher frequency of oliguria, cardiac arrhythmia, dyspn ea, and pulmonary rales. Logistic regression showed that the only independe nt factor associated with death was oliguria (odds ratio [OR] = 8.98). The presence of arthralgia (OR = 4.71), dehydration (OR = 6.26), dyspnea (OR = 17.7),and pulmonary rales (OR = 9.91) increased after 1994. These data sugg est that in Well's disease the clinical patterns have changed and the prese nce of oliguria is a risk factor for death.