Ramachandran S, Rajapakse C N, Perera M V, Yoganathan M
J Trop Med Hyg. 1976 Jul;79(7):158-60.
The renal profile was studied in 61 patients having leptospirosis. Leptospira-induced acute renal failure conformed to one of two distinct clinical patterns, either oliguric on non-oliguric renal failure. The prognosis was excellent in the latter variety of renal failure and mortality was confined to patients with oliguric renal failure, where severe glomerular and widespread tubulo-interstitial lesions were invariably present. These patients had unfavourable prognostic features during life, such as prolonged oliguria and anuria, absence of a diruetic phase, persistent elevations in BUN and persistently low urea excretion. The prognostic significance of the age of the patients, hypotension and jaundice in relation to the occurrence and type of acute renal failure have been discussed. Retrospective observations indicate that both a vasculotoxic or haemorrhagic state and oliguric acute renal failure are important causes for mortality in human leptospiral infections.
对61例钩端螺旋体病患者的肾脏情况进行了研究。钩端螺旋体引起的急性肾衰竭符合两种不同临床类型之一，即少尿型或非少尿型肾衰竭。后一种肾衰竭类型预后良好，死亡仅限于少尿型肾衰竭患者，这些患者总是存在严重的肾小球和广泛的肾小管间质病变。这些患者在病程中具有不良预后特征，如少尿和无尿持续时间长、无利尿期、血尿素氮持续升高以及尿素排泄持续降低。已讨论了患者年龄、低血压和黄疸与急性肾衰竭的发生及类型相关的预后意义。回顾性观察表明，血管毒性或出血状态以及少尿型急性肾衰竭都是人类钩端螺旋体感染致死的重要原因。
