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Title: Renal magnesium wasting and tubular dysfunction in leptospirosis
Authors: Sookkasem Khositseth
Niwatchai Sudjaritjan
Paiboon Tananchai
Sompong Ong-Ajyuth
Visith Sitprija
Visith Thongboonkerd
Faculty of Medicine, Thammasat University
Nan Hospital
Mahidol University
Queen Saovabha Memorial Institute
Faculty of Medicine, Siriraj Hospital, Mahidol University
Keywords: Medicine
Issue Date: 1-Mar-2008
Citation: Nephrology Dialysis Transplantation. Vol.23, No.3 (2008), 952-958
Abstract: Background. Tubulo-interstitial nephritis is the main cause of acute renal injury in leptospirosis. The aim of this study was to evaluate renal tubular function and excretion of solutes in leptospirosis patients during a recent outbreak of leptospirosis in Nan province, Thailand. Methods. Clinical manifestations were recorded and routine laboratory tests were performed upon admission. Renal tubular functions including tubular reabsorption of phosphate (TRP), fractional excretion of magnesium (FEMg), urinary calcium to creatinine ratio (Uca/cr), urine N-acetyl-β-d glucosaminidase (NAG) and urine β2-microglobulin were serially monitored during 2 weeks after admission. Results. A total of 20 leptospirosis patients were recruited. Nine (45%) patients had acute renal failure (ARF). Increased urine NAG and β2-microglobulin, which indicate proximal tubular dysfunction, were demonstrated in all 20 (100%) patients. Fifteen (75%) patients had hypermagnesuria, whereas 10 (50%) patients had decreased TRP. Renal magnesium (Mg) and phosphate (P) wasting caused hypomagnesaemia and hypophosphataemia in nine and three patients with ARF, respectively. These abnormal findings significantly improved within 2 weeks after admission. Conclusions. We conclude that renal Mg and P wasting commonly occur in patients with leptospirosis. The measurement of Mg and P levels in both serum and urine of leptospirosis patients, especially those with ARF, is therefore highly recommended. © The Author [2007]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.
ISSN: 14602385
Appears in Collections:Scopus 2006-2010

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