• Unexplained fever/jaundice/acute renal failure

• Neglected CKDu patients

• High-risk occupations

• Post-typhoon/flood high-risk groups

• Critical patients with multiple organ failure

• International partners

Linkou Chang Gung Memorial Hospital's Department of Nephrology and Kidney Research Center, led by Prof. Chih-Wei Yang (College of Medicine & Kidney Research Center), began noticing the puzzling acute renal failure that left physicians stumped during his 1985-1990 residency. Following case re-emergence in 1996, the team published the seminal 1997 Am J Kidney Dis paper (IF 11.072), "Leptospirosis: An ignored cause of acute renal failure in Taiwan." The team built a comprehensive diagnosis-treatment-research system: (1) clinical triad alert (fever + jaundice + acute kidney injury); (2) BSL-2 leptospirosis laboratory area established 2003 (4F Research Building, Advanced Medical Park) for IgM rapid testing—results within 2 hours and immediate physician notification; (3) antibiotic treatment (severe: Penicillin/Ceftriaxone IV; mild outpatient: Doxycycline/Azithromycin/Amoxicillin); (4) 2-hour standardized diagnosis-treatment workflow. 2000-2022 cumulative rapid tests: 1,215 patients, 66 positive (5.4%); since rapid IgM serology introduction in 2003, leptospirosis mortality became zero. Research published in Am J Kidney Dis, Shock, and other SCI journals (multiple IF>3.5). Covered Taiwan 2009-2016 post-Morakot typhoon and flood cases; global incidence 1.03M/year with 2.90M DALYs; major 2019 Philippines outbreak (NKTI basketball court converted to dialysis ICU).

• World-first publication on Taiwan leptospirosis ARF (1997 Am J Kidney Dis)

• In-house BSL-2 leptospirosis rapid testing lab

• Results within 2 hours, physician notified

• Zero mortality since 2003 rapid IgM introduction

• Global leader from bedside to bench

• Deciphers unexplained CKDu

• 1,215 rapid tests (2000-2022)

• 66 positive patients (5.4%)

• Global incidence 1.03M/yr

• Global 2.90M DALYs/yr

• Cross-team (Nephrology/ID/Lab)

• Cooperation with Philippines, SE Asia

• Zero mortality since 2003 rapid IgM

• Diagnosis within 2 hours

• Improved survival in multi-organ failure

• Precise & effective antibiotic therapy

• Early diagnosis saves critical patients

• Extended from AKI research to CKDu

• Standardized diagnosis-treatment workflow

• BSL-2 lab biosafety protection

• Two-stage MAT serum antibody validation

• Strict case classification (suspect/seropositive/probable/confirmed)

• Antibiotics within 2 hr of positive notice

• Nephrology consultation within 24 hr

• Improved survival rates for severely ill

• Zero mortality in multi-organ failure

• Recognized intl cooperation with NKTI Philippines

• Mass-casualty rescue (typhoon/flood)

• Provided rescue experience for 916 cases (106 deaths) in Philippines

• Cross-team unified recognition

• 1997 Am J Kidney Dis IF 11.072 seminal publication

• Shock IF 3.533 IgM rapid test rescue study

• Cited in Nat Rev Microbiol global re-emergence

• Taiwan experience published globally

• Intl cooperation with NKTI Philippines

• Widely cited by intl institutions

• Reveals globally neglected cause of acute/chronic kidney disease

• Provides rescue experience for tropical countries

• Cross-domain study of renal fibrosis mechanism

• First to propose cause of CKDu

• International linkage & global kidney disease outlook

• Improves protection for at-risk occupations