Renal involvement in leptospirosis: new insights into pathophysiology and treatment
Renal involvement in leptospirosis: new insights into pathophysiology and treatment
复制标题
DOI：
10.1590/s1413-86702008000300016
复制
发表时间：
2008-06-01
影响因子：
3.4
通讯作者：
Seguro, Antônio Carlos
中科院分区：
文献类型：
--
作者：
Cerqueira, Thaís Bandeira;Athanazio, Daniel Abensur;Seguro, Antônio Carlos
急性肾功能衰竭(ARF)是钩端螺旋体病最常见的并发症之一，但其发病机制尚不清楚。钩端螺旋体肾病涉及多种机制，新数据支持特殊离子转运缺陷的作用。除了抗生素治疗外，钩端螺旋体病的ARF治疗还需要透析治疗，早期开始是最有效的。透析是标准的支持性治疗，尽管最近的证据表明，替代治疗如血浆置换和血液滤过对临床有好处。临床改善后不久，肾脏恢复正常。对肾功能障碍的主要机制的理解将有助于开发额外的治疗工具，以改进钩端螺旋体肾病的支持治疗。本文就钩端螺旋体急性肾功能衰竭的发病机制和治疗进展进行综述。
Acute renal failure (ARF) is one of the most common complications of leptospirosis although the causal mechanisms are still unclear. Diverse mechanisms are implicated in leptospiral nephropathy and new data supports the role of peculiar ion transport defects. Besides antibiotic therapy, ARF management in leptospirosis requires dialytic therapy which is most efficient when started early. Dialysis is the standard supportive therapy even though recent evidence suggests clinical benefit from alternative treatments such as plasmapheresis and hemofiltration. Renal recovery is achieved soon after clinical improvement. The comprehension of the primary mechanisms of renal dysfunction will be helpful in the development of additional therapeutic tools for improving supportive therapy for leptospiral nephropathy. This review discusses new insights into mechanisms implicated in leptospiral ARF and recent advances in treatment.