Negative Association of Occult Leptospirosis Infection and Chronic Kidney Disease in North Taiwan

BACKGROUND: The prevalence and incidence of end-stage renal disease are high in Taiwan. Acute leptospirosis infection often causes renal tubulointerstitial disease, but the association of occult leptospirosis and renal disease is unclear. The aim of this study is to define the possible association between occult leptospirosis infection and chronic kidney disease (CKD). METHODS: In this prospective observational cohort study, 371 patients with CKD and 100 residents without CKD in the same community were included. Microscopic agglutination test (MAT) was employed to detect occult leptospirosis. Both renal progression and microalbuminuria were also monitored during a follow-up period of 42 months. RESULTS: Low prevalence of positive MAT is found in normal and CKD subjects. There was no significant difference in amount of microalbuminuria between MAT positive and negative subjects (527.52 ± 125.18 vs. 728.2 ± 216.23, mg/day, P ＞ 0.05). Logistic analysis for CKD progression did not show different CKD progression between MAT positive and negative groups. CONCLUSION: The prevalent rates of positive MAT in normal and CKD subjects were similar. There was also no difference in microalbuminuria and CKD progression between MAT positive and negative subjects. Our findings suggested that occult leptospirosis might not be associated with development and progression of CKD in North Taiwan.