Narrative review of generalities of the genus Leptospira and its virulence factors associated with renal pathophysiology

Abstract

Worldwide,leptospirosis is the most highly prevalent zoonosis. Although the wide range of clinical manifestations of leptospirosis in humans is well-documented, knowledge of the mechanisms throughwhich this pathogen causes kidney disease remains limited. This narrative review of the scientific literature presents experimental studies of pathophysiology and kidney disease in leptospirosis, both in humans and animals, and the results show thatvirulence factors are involved in kidney damage by inducinginterstitial tubular nephritis, which is the most frequent pathological manifestation, additionally, to the acute non-oliguric renal lesion withhypokalemia, and loss of magnesium and sodium. Finally, it isconcluded that in leptospirosis, the initial lesion in the kidney is caused bydamage to the cell membrane of the proximal tubular region cells by pathogenic Leptospira virulence factors, thus exacerbating theimmune response.

Keywords

• kyned failure; leptospira; leptospirosis; pathogenesis; virulence factors.