RESUMO
Leptospirosis is a bacterial disease disseminated through the centuries in the whole world which causes symptoms that go from self-limited diseases to hemorrhagic manifestations and organ failure, including acute kidney injury (AKI), composing the severe disease known as the Weil's syndrome. Mortality rates varies according to the clinical presentation and usually increases when kidney injury is present, and is even higher in the setting of pulmonary hemorrhage. There are recent advances in the search for novel biomarkers of renal involvement and early detection of AKI in leptospirosis, as well as in its pathophysiology. We review in this article the clinical aspects of leptospirosis-associated AKI and the perspectives for future research.
RESUMO
Background: Despite dialysis being performed in critically ill patients for more than 30 years, it is still controversial whether intermittent or continuous dialysis yields superior end results. Objective: To compare intermittent renal replacement therapy (RRT) and continuous RRT to establish which is superior to the other in patients with acute kidney injury. Results: With respect to hemodynamic stability, continuous RRT seems to be superior to intermittent RRT although there are no significant differences between the two modalities in terms of survival and recovery of renal function. Conclusion: More severe patients might obtain greater benefit from continuous RRT while the less severe patients might take advantage from daily extended or intermittent dialysis.