Incidence and Predictive Factors of Acute Kidney Injury in Leptospirosis: A Prospective Cohort Analysis

Introduction: Leptospirosis is a zoonotic disease caused by Leptospira species, with acute kidney injury (AKI) as a frequent and severe complication. This study aims to examine the incidence, risk factors, and outcomes of leptospirosis-associated AKI, particularly focusing on its progression and mortality impact. Methodology: A prospective observational study was conducted at Wockhardt Hospitals, Mumbai, from May to September 2024. The study included 35 patients with confirmed leptospirosis. Data on demographics, clinical history, laboratory findings, and AKI stages (based on Acute Kidney Injury Network criteria) were collected. Statistical analyses, including univariate logistic regression, identified risk factors for AKI progression and mortality. Results: Among the cohort, 45.71% developed stage 1 AKI, 14.29% stage 2, and 40% stage 3. Mortality was highest in stage 3 AKI (35.71%). Univariate analysis identified elevated ALT as a predictor of AKI progression, while younger patients, hyperkalaemia, raised TLC, and hyperbilirubinemia were associated with increased mortality risk. Conclusions: This study underscores the prevalence and severity of AKI in leptospirosis, revealing significant morbidity and mortality. Monitoring serum creatinine, platelet count (thrombocytopenia), and liver function tests (ALT and bilirubin) is critical for early AKI detection and prognosis. The findings support implementing targeted interventions and further research into leptospirosis-associated AKI to improve outcomes.