Envolvimento da função renal em pacientes com leishmaniose visceral (calazar)

Filho, Natalino Salgado; Ferreira, Telma Márcia A.F.; Costa, Jackson Maurício Lopes

doi:10.1590/s0037-86822003000200004

Cited by 45 publications

(25 citation statements)

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“…Salgado Filho et al [7], in a prospective study involving 11 patients with VL, found microalbuminuria above the normal range in 81.8% of them, indicating a possible association between this marker and renal dysfunction. In the present study, microalbuminuria was similar in both groups, suggesting that albuminuria in VL is transitory and has the potential of being fully reversible after treatment, conferring a favorable long-term prognosis to these patients regarding GFR.…”

Section: Discussionmentioning

confidence: 99%

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Renal Function Improvement with Pentavalent Antimonial Agents in Patients with Visceral Leishmaniasis

Daher

Rocha²,

Oliveira

et al. 2011

Am J Nephrol

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Background: The aim of this study is to investigate tubular and glomerular function after visceral leishmaniasis (VL) treatment with pentavalent antimonials. Methods: This is a prospective study including 14 patients with VL diagnosis treated with pentavalent antimonials. Urine acidification and concentration tests were performed. Estimated glomerular filtration rate (eGFR), fractional excretion of sodium (FE_Na) and potassium (FE_K) and free water clearance (C_H2O) were measured to assess glomerular and tubular function. Results: The VL group had a significantly lower FE_K, serum sodium and plasma osmolality (P_osm). No significant differences were found regarding proteinuria, eGFR, FE_Na or C_H2O. Patients in the VL group had lower urinary osmolality (U_osm) before DDAVP use when compared to the control group, as well as a lower U/P_osm. The urinary pH before and after CaCl₂ load was higher in the VL group. Conclusion: This study shows evidence of reversal of some tubular dysfunction in VL, but other dysfunctions may persist, especially urinary acidification capacity.

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Section: Discussionmentioning

confidence: 99%

“…As a consequence of the intense parasitism of the reticular endothelial system, VL patients present with accentuated anemia, leukopenia and thrombocytopenia, as well as increased plasmatic levels of gamma globulins [7]. Pentavalent antimonial agents are the treatment of choice for VL.…”

Section: Introductionmentioning

confidence: 99%

Renal Function Improvement with Pentavalent Antimonial Agents in Patients with Visceral Leishmaniasis

Daher

Rocha²,

Oliveira

et al. 2011

Am J Nephrol

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“…Além disso, infecções parasitárias crônicas estão frequentemente associadas à formação de imunocomplexos que podem se depositar nos glomérulos renais e tubulointersticiais, produzindo glomerulonefrite e nefrite intersticial com o comprometimento da função renal 37,38 . O edema, um sinal clínico na LV, embora sem associação estatística neste estudo (teste exato de Fisher p>0,05), poderia estar relacionado com o envolvimento renal e a diminuição de proteínas, assim como já observado por Salgado-Filho, Ferreira e Costa 39 . Outro fator que pode influenciar o curso da doença é a comorbidade, uma condição que pode ocorrer frequentemente em pacientes com LV 25 .…”

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Mortalidade por leishmaniose visceral: aspectos clínicos e laboratoriais

Oliveira

Fernandes

Dorval

et al. 2010

Rev. Soc. Bras. Med. Trop.

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RESUMO ABSTRACTIntroduction: Visceral leishmaniasis is a systemic infectious disease of broad geographical distribution, characterized by high potential for lethality. With the purpose of contributing towards reducing mortality and helping healthcare professionals in clinical management of patients with this disease, this paper aimed to investigate the clinical and laboratory characteristics of cases with a fatal outcome in hospitals in Campo Grande, Mato Grosso do Sul, between 2003 and 2008. Methods: Fifty-five medical files on patients who died due to visceral leishmaniasis were analyzed. Results: Among the 55 patients studied, 37 were from the municipality of Campo Grande; 41 (74.5%) were males; and age over 40 years predominated. The patients presented with fever in 89.1% of the cases. The duration of the illness from the onset of symptoms to hospitalization was 78.2 days on average. Leukopenia was seen in 85.5% of the patients. Comorbidities were present in 39 (70.9%) patients; malnutrition and alcoholism were the most frequent of these. Confirmation of the diagnosis occurred on average 6.7 days after admission. Pentavalent antimoniate was the drug most used, and 87.5% of the patients presented some type of adverse reaction. Bacterial infections occurred in 36 patients and were one of the causes of death in 27 (49%). Conclusions: The data showed that early identification of these clinical and laboratory characteristics, at the time when patients are first attended, is extremely important for reducing mortality through instituting efficient therapeutic and prophylactic measures.

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“…Renal involvement has been described in visceral leishmaniasis (kala-azar), including from mild urinary abnormalities to severe glomerular involvement and renal failure [7-10]. Renal failure in kala-azar is thought to occur due to interstitial nephritis secondary to immune complex deposition and hypersensitivity to pentavalent antimonials [6,11-13].…”

Section: Introductionmentioning

confidence: 99%

Renal function evaluation in patients with American Cutaneous Leishmaniasis after specific treatment with pentavalent antimonial

et al. 2012

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BackgroundRenal evaluation studies are rare in American Cutaneous Leishmaniasis (ACL). The aim of this study is to investigate whether specific treatment reverts ACL-associated renal dysfunction.MethodsA prospective study was conducted with 37 patients with ACL. Urinary concentrating and acidification ability was assessed before and after treatment with pentavalent antimonial.ResultsThe patients mean age was 35.6 ± 12 years and 19 were male. Before treatment, urinary concentrating defect (U/Posm <2.8) was identified in 27 patients (77%) and urinary acidification defect in 17 patients (46%). No significant glomerular dysfunction was observed before and after specific ACL treatment. There was no reversion of urinary concentrating defects, being observed in 77% of the patients before and in 88% after treatment (p = 0.344). Urinary acidification defect was corrected in 9 patients after treatment, reducing its prevalence from 40% before to only 16% after treament, (p = 0.012). Microalbuminuria higher than 30 mg/g was found in 35% of patients before treatment and in only 8% after treatment. Regarding fractional excretion of sodium, potassium, calcium, phosphorus and magnesium, there was no significant difference between pre and post-treatment period.ConclusionAs previously described, urinary concentrating and acidification defects were found in an important number of patients with ACL. Present results demonstrate that only some patients recover urinary acidification capacity, while no one returned to normal urinary concentration capacity.

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Envolvimento da função renal em pacientes com leishmaniose visceral (calazar)

Abstract: Resumo Envolvimento da função renal em pacientes com leishmaniose visceral (calazar).

Cited by 45 publications

References 13 publications

Renal Function Improvement with Pentavalent Antimonial Agents in Patients with Visceral Leishmaniasis

Renal Function Improvement with Pentavalent Antimonial Agents in Patients with Visceral Leishmaniasis

Mortalidade por leishmaniose visceral: aspectos clínicos e laboratoriais

Renal function evaluation in patients with American Cutaneous Leishmaniasis after specific treatment with pentavalent antimonial

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