[Clinical and pathogenic evaluation of acid-base, gas and electrolyte homeostasis in patient with leptospirosis and acute renal insufficiency].

: With the purpose of further perfecting the pathogenetic therapy, indices for the acid-base status were studied together with those for the electrolyte exchange in the time-related course of the disease in patients with grave leptospiral jaundice presenting with acute renal failure (ARF). Patients with leptospirosis running a grave course and ARF display changes in the acid-base status and gas composition of the blood. Patients presenting with oligoanuric ARF and fatal outcome develop uncompensated metabolic acidosis (11.8%), in case of favourable outcome--metabolic acidosis with compensation by respiratory alkalosis (29.4%). The polyuric ARF stage is characterized by a mixed metabolic and respiratory alkalosis (58.8%). Results of studies made warrant use of indices for the acid-base, gas, and electrolyte balance to assess severity and prognosis of leptospirosis, to determine the stage of ARF, and to develop rational pathogenetic therapies.