Acute kidney injury in visceral leishmaniasis: a cohort of 10 patients admitted to a specialized intensive care unit in northeast of Brazil

ObjectiveTo describe co-infections, clinical manifestations, comorbidities and outcome of patients with visceral leishmaniasis and AKI.MethodsThis is a case study with ten patients with confirmed diagnosis of VL admitted to the reference ICU of Northeast of Brazil during 6 years, with renal injury. Clinical and laboratory parameters were evaluated in admission, period of hospitalization and outcome.ResultsThis study found 10 patients with VL in a group of 253 patients admitted to the ICU with AKI. The main signs and symptoms presented at admission were weight loss, fever, splenomegaly, jaundice, anorexia, asthenia, bleeding and vomits. The main co-infections were: AIDS, tuberculosis and leprosy. Patients were classified in RIFLE criteria. RIFLE-F patients were younger and had a longer time between onset of symptoms and hospital admission. Death was observed in 60% of cases. The causes of death were septic shock, respiratory insufficiency and multiple organ dysfunction.ConclusionsAKI is an important complication in VL. The progression of the disease and their complications can achieve high level of severity, even in the absence of comorbidities or co-infections. The high mortality in this group alerts to the importance of adequate management of these patients.