ArticleVirchows Archiv : an international journal of pathology2010
Acute kidney injury in human leptospirosis: an immunohistochemical study with pathophysiological correlation.
Article in Virchows Archiv : an international journal of pathology, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed, 60 citations in OpenAlex.
- Article
- Leptospirosis.Nature reviews. Disease primers · 2025Review
- Exudative glomerulonephritis associated with acute leptospirosis in dogs.Veterinary pathology · 2024Article
- A Rare Case of Longitudinally Extensive Transverse Myelitis Following Febrile Illness: A Case Report.Cureus · 2024Article
- Cellular Pathophysiology of Leptospirosis: Role of Na/K-ATPase.Microorganisms · 2023Review
- Authors' Reply: Rhabdomyolysis-Induced Acute Kidney Injury in Austere Environments Highlights Need for Specific Treatment.Kidney international reports · 2023Article
- Prevalence of leptospirosis among patients attending renal and general outpatient clinics in Mulago Hospital, Kampala, Uganda.Scientific reports · 2022Article
- Going Micro in Leptospirosis Kidney Disease.Cells · 2022Review
- Weil's disease in a young homeless man living in Lisbon.BMJ case reports · 2020Article
- Leptospirosis in the elderly: the role of age as a predictor of poor outcomes in hospitalized patients.Pathogens and global health · 2019Article
- Thai-Lepto-on-admission probability (THAI-LEPTO) score as an early tool for initial diagnosis of leptospirosis: Result from Thai-Lepto AKI study group.PLoS neglected tropical diseases · 2018Article
- Pathology and pathogenesis of human leptospirosis: a commented review.Revista do Instituto de Medicina Tropical de Sao Paulo · 2018Review
- Lp25 membrane protein from pathogenic Leptospira spp. is associated with rhabdomyolysis and oliguric acute kidney injury in a guinea pig model of leptospirosis.PLoS neglected tropical diseases · 2017Article
- The course and outcome of renal failure due to human leptospirosis referred to a hospital in North of Iran; A follow-up study.Caspian journal of internal medicine · 2016Article
- Proteomic analysis of urine exosomes reveals renal tubule response to leptospiral colonization in experimentally infected rats.PLoS neglected tropical diseases · 2015Article
- Leptospirosis in humans.Current topics in microbiology and immunology · 2015Review
- Human hemorrhagic pulmonary leptospirosis: pathological findings and pathophysiological correlations.PloS one · 2013Article
- Multiple leptospiral sphingomyelinases (or are there?).Microbiology (Reading, England) · 2012Review
- Renal involvement in leptospirosis: the effect of glycolipoprotein on renal water absorption.PloS one · 2012Article
- Comparative proteomic analysis of differentially expressed proteins in the urine of reservoir hosts of leptospirosis.PloS one · 2011Article
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Tubulointerstitial nephritis is a common clinicopathological finding in leptospirosis. Clinically, nonoliguric acute kidney injury (AKI), hypokalemia, sodium, and magnesium wasting frequently occur in leptospirosis. The exact mechanisms of renal involvement remain largely unclear. Immunohistochemistry to detect expression of the endogenous sodium/hydrogen exchanger isoform 3 (NHE 3), aquaporin 1 and 2, alpha-Na(+)K(+)ATPase, and sodium-potassium-chloride cotransporter in its NKCC2 isoform was performed on kidneys removed during autopsy of human leptospirosis cases and kidneys removed during autopsy of human non-leptospirosis cases with and without evidence of acute tubular necrosis (ATN). A decrease in NHE 3, aquaporin 1, and alpha-Na(+)K(+)ATPase expression occurred in proximal convoluted tubule cells. Expression of aquaporin 1 was preserved along the descending thin limb of the loop of Henle in the outer medulla. alpha-Na(+)K(+)ATpase expression was essentially preserved in the distal tubules, i.e., the thick ascending limb of the loop of Henle, macula densa, and distal convoluted tubule. Aquaporin 2 expression in the collecting tubules was enhanced compared to those of non-leptospirotic kidneys. NKCC2 cotransport isoform was expressed in the thick ascending limb of the loop of Henle and was essentially preserved in leptospirotic kidneys. Primary injury of the proximal convoluted tubules is regarded as the hallmark of the kidney in leptospirosis. Sodium and water transport are particularly affected with increased distal potassium excretion, hypokalemia, and polyuria. Enhanced expression of aquaporin 2 in medullary collecting tubules is probably an attempt to retain water during the nonoliguric phase of renal failure.
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