A cross-sectional study: Insubstantial serological evidence for the association between chronic renal disease and leptospirosis in Badulla and Kandy district, Sri Lanka

Abstract

Chronic kidney disease (CKD) and chronic kidney disease of uncertain etiology (CKDu) are chronic renal diseases that pose a significant health burden in Sri Lanka. Leptospirosis is a bacterial zoonosis that primarily damages kidney tissues via colonization of Leptospira spp. in the renal tubules and is a suspected etiological agent of CKDu. Since Sri Lanka is a leptospirosis endemic country where outbreaks of the disease have been reported, this study aimed to find the association between leptospirosis and chronic renal disease in two geographically distinct regions of Sri Lanka, Kandy (CKDu non-endemic) and Badulla (CKDu endemic) districts. Forty-nine chronic renal disease patients and 135 controls from Kandy and 89 chronic renal disease patients and 149 controls from Badulla were examined serologically by microscopic agglutination test with a panel of 11 Leptospira serogroups. A seroprevalence of 35.3% and 32.5% for leptospirosis was observed in the Girandurukotte CKDu group and Girandurukotte control group respectively, while a seroprevalence of 36.7% and 31.9% were observed in the Kandy CKDu group and Kandy control group respectively. No statistically significant differences in leptospirosis seropositivity were observed between the chronic renal disease and control groups in both districts. However, further longitudinal studies assessing renal colonization among chronic renal patients and healthy individuals are required to conclusively state whether leptospirosis plays an important role in chronic renal disease development and/or progression in Sri Lanka.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

This study was partly supported by a research grant from University of Peradeniya (URG/2018/28M) and National Science Foundation of Sri Lanka (RPHS/2016/CKDu/06). This funding source had no role in the design of this study and did not have any role during its execution, analyses, interpretation of the data, or decision to submit results.

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Ethical clearance for this study was obtained from the institutional Ethical Review Committee, Faculty of Medicine, University of Peradeniya (UoP), Sri Lanka (2016/EC/64).

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

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I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

Data Availability

Data has been made available as Supplementary Materials

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