Risk Factors for Acute Kidney Injury in Visceral Leishmaniasis (Kala-Azar)

Oliveira, Michelle Jacintha Cavalcante; Júnior, Geraldo B. Silva; Abreu, Krasnalhia Lívia S.; Rocha, Natália A.; Garcia, Ana Valeska V.; Franco, Luiz F. L. G.; Mota, Rosa Maria Salani; Libório, Alexandre Braga; Daher, Elizabeth De Francesco

doi:10.4269/ajtmh.2010.09-0571

Cited by 35 publications

(28 citation statements)

References 21 publications

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“…Renal involvement is considered rare, presenting as hematuria, proteinuria or renal function impairment [2]. There have been few studies regarding tubular dysfunction in VL, and studies on renal function after VL treatment with pentavalent antimonials are even less common [8]. …”

Section: Discussionmentioning

confidence: 99%

“…Renal abnormalities caused by leishmanias have been well documented in experimental animal studies and comprise interstitial and glomerular abnormalities [8]. The main pathophysiological mechanism by which VL affects the kidneys probably includes immune complex disease as in other parasitic infections, such as malaria and schistosomiasis [9,10].…”

Section: Introductionmentioning

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%

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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“…The bilirubin levels in female-2 were also at the upper limit of the value range for uninfected females. Hemolytic disease is among the causes of hyperbilirubinemia (Willard & Tvedtenen 2012), and increased levels of bilirubin have been reported in humans suffering from visceral leishmaniosis (Oliveira et al 2010). Female-2 also presented increased levels of chloride, which can be indicative of renal failure (DiBartola 2012).…”

Section: Discussionmentioning

confidence: 99%

Serum chemistry reference values for the common genet (Genetta genetta): variations associated withLeishmania infantuminfection

Millán

Chirife²,

Altet³

2014

Veterinary Quarterly

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Background: The role of wildlife in the epidemiology of leishmaniosis in under debate, and determining whether infection with Leishmania infantum causes illness in wild carnivores is important to determine its potential role as a reservoir. Objectives: To provide for the first time serum biochemistry reference values for the common genet (Genetta genetta), and to determine variations associated with L. infantum infection. Methods: Twenty-five serum biochemistry parameters were determined in 22 wild-caught genets. Blood samples were analyzed for L. infantum DNA by means of real-time polymerase chain reaction (PCR). Results: Two female genets were positive for L. infantum DNA but did not show any external clinical sign upon physical examination. Among other variations in the biochemistry values of these genets, one presented a higher concentration of gamma-globulins and cholesterol, whereas the other genet presented increased creatinine, bilirubin, and chloride levels when compared to uninfected females. Sex-related differences in some parameters were also reported. Conclusion: Infection with L. infantum may sometimes be accompanied by abnormal serum biochemistry in wild carnivores. Clinical importance: Clinical disease may occur in L. infantum-infected wild carnivores. This has implications in the epidemiology of leishmaniosis. In addition, the data provided here would also be useful as reference values for researchers or rehabilitators working with the common genet.

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“…Healing of CL lesions was achieved with a total dose of 600mg 62 even though amphotericin B is associated with dose-dependent nephrotoxicity, particularly when the daily dose is greater than 35mg. Risk factors that predispose patients to this condition are as follows: body weight over 90kg, concomitant cyclosporine or aminoglycoside usage, chronic renal failure (CRF) 63 , male sex, advanced age and jaundice 64 . Patients with more than two risk factors for nephrotoxicity are potential candidates for alternative therapy 63 .…”

Section: Resultsmentioning

confidence: 99%

Treatment of American tegumentary leishmaniasis in special populations: a summary of evidence

Silva

Galvão

Gomes

et al. 2013

Rev. Soc. Bras. Med. Trop.

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Revista da Sociedade Brasileira de Medicina Tropical 46(6):669-677, Nov-Dec, 2013http://dx.doi. org/10.1590/0037-8682-0104-2013 Address to: Dr a Juliana Saboia Fontenele e Silva. Lab. ABSTRACT We aimed to assess and synthesize the information available in the literature regarding the treatment of American tegumentary leishmaniasis in special populations. We searched MEDLINE (via PubMed), EMBASE, LILACS, SciELO, Scopus, Cochrane Library and mRCT databases to identify clinical trials and observational studies that assessed the pharmacological treatment of the following groups of patients: pregnant women, nursing mothers, children, the elderly, individuals with chronic diseases and individuals with suppressed immune systems. The quality of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. The available evidence suggests that the treatments of choice for each population or disease entity are as follows: nursing mothers and children (meglumine antimoniate or pentamidine), patients with renal disease (amphotericin B or miltefosine), patients with heart disease (amphotericin B, miltefosine or pentamidine), immunosuppressed patients (liposomal amphotericin), the elderly (meglumine antimoniate), pregnant women (amphotericin B) and patients with liver disease (no evidence available). The quality of evidence is low or very low for all groups. Accurate controlled studies are required to fi ll in the gaps in evidence for treatment in special populations. Post-marketing surveillance programs could also collect relevant information to guide treatment decision-making.

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Risk Factors for Acute Kidney Injury in Visceral Leishmaniasis (Kala-Azar)

Cited by 35 publications

References 21 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

Serum chemistry reference values for the common genet (Genetta genetta): variations associated withLeishmania infantuminfection

Treatment of American tegumentary leishmaniasis in special populations: a summary of evidence

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