Insufficient serological evidence of the association between chronic kidney disease and leptospirosis in Badulla and Kandy districts, Sri Lanka

Abstract

Chronic kidney disease (CKD) and chronic kidney disease of uncertain etiology (CKDu) are chronic renal diseases that pose a significant health burden in Sri Lanka. Leptospirosis is a bacterial zoonosis that primarily damages kidney tissues via colonization of Leptospira spp. in the renal tubules and is a suspected etiological agent of CKDu. Since Sri Lanka is a leptospirosis endemic country where outbreaks of the disease have been reported, this study aimed to find the association between leptospirosis and chronic renal disease in two geographically distinct regions of Sri Lanka, Kandy (CKDu non-endemic) and Badulla (CKDu endemic) districts. Forty-nine chronic renal disease patients and 135 controls from Kandy and 89 chronic renal disease patients and 149 controls from Badulla were examined serologically by microscopic agglutination test with a panel of 11 Leptospira serogroups. A seroprevalence of 35.3% and 32.5% for leptospirosis was observed in the Girandurukotte CKDu group and Girandurukotte control group respectively, while a seroprevalence of 36.7% and 31.9% were observed in the Kandy CKDu group and Kandy control group respectively. No statistically significant differences in leptospirosis seropositivity were observed between the chronic renal disease and control groups in both districts. However, further longitudinal studies assessing renal colonization among chronic renal patients and healthy individuals are required to conclusively state whether leptospirosis plays an important role in chronic renal disease development and/or progression in Sri Lanka.