P1218outcome of Renal Replacement Therapy in Leptospirosis Associated Aki - Peritoneal Dialysis vs Hemodialysis

Abstract

Background and Aims Leptospirosis is a common zoonotic disease and acute kidney injury(AKI) is very commonly associated with it, often seen as a marker of disease severity. Renal replacement therapy(RRT) is often required in patients with clinical indications like uremia, oliguria, pulmonary edema and hyperkalemia. The two classical modalities employed for RRT are hemodialysis and peritoneal dialysis. We designed this study to evaluate the clinical outcome among patients with leptospirosis associated AKI requiring dialysis. Method: Basic clinical and demographic parameters of our patients were studied. The dialysis modality for each patient was decided based on their predominant clinical presentation. The duration of dialysis dependency and hospitalization along with final clinical outcome in terms of renal recovery or death were recorded. Appropriate statistical methods were used for analysis of results Results Thirty two patients underwent renal replacement therapy for leptospirosis associated AKI. Among them 22 received hemodialysis and 10 received peritoneal dialysis. Mortality in our group was 12.5%. Multiorgan involvement, need for mechanical ventilation and oliguric AKI were observed to be predictors of mortality along with hyperbilirubinemia, hypoalbuminemia, hyperkalemia and elevated creatinine phosphokinase levels. Peritoneal dialysis was observed to be associated with a shorter duration of dialysis dependency and hospitalization, however no significant impact on mortality was noticed. Conclusion Leptospirosis is a disease of great epidemiological significance in our part of the county. Prompt initiation of RRT in indicated patients leads to an acceptable clinical outcome with good renal recovery. Peritoneal dialysis is slowly losing popularity, which may be revived with proper training of medical personnel and good patient selection.