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Analysis of renal function in onchocerciasis patients before and after therapy
G D Burchard1, T Kubica, F W Tischendorf
1Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany.
Abstract:
The occurrence of renal abnormalities was investigated in patients with onchocerciasis in comparison to individuals without onchocerciasis in Guinea. Serum creatinine levels, excretion of urinary marker proteins, and kidney size by ultrasound were determined. A high prevalence of glomerular as well as tubular dysfunctions was observed; however, no association with onchocerciasis could be detected. We also hypothesized that patients with hyperreactive onchocerciasis might be prone to develop immune-mediated glomerular disorders; however, this could not be verified. Following treatment with ivermectin, a slight but significant increase in the excretion of urinary albumin and alpha1-microglobulin was seen five days after treatment in all treated patients, whereas levels of proteinuria were significantly higher five days after treatment only in patients with high microfilarial densities. Our results indicate that ivermectin can cause glomerular and tubular disturbances in patients with onchocerciasis; however, these are minor and do not seem to be clinically relevant.
Insights
This study found no link between onchocerciasis and kidney problems in Guinea. Ivermectin treatment caused minor, temporary renal changes in patients, which were not clinically significant.
Area of Science:
- Tropical medicine
- Nephrology
- Parasitology
Background:
- Onchocerciasis, a parasitic disease, can affect various organs.
- Renal involvement in onchocerciasis is not well understood.
- Hyperreactive onchocerciasis may be linked to immune-mediated kidney issues.
Purpose of the Study:
- To investigate renal abnormalities in Guinean patients with onchocerciasis compared to controls.
- To assess the impact of ivermectin treatment on kidney function markers.
Main Methods:
- Evaluated serum creatinine, urinary protein excretion, and kidney size via ultrasound.
- Compared onchocerciasis patients with healthy individuals.
- Monitored renal markers before and after ivermectin treatment.
Main Results:
- High prevalence of glomerular and tubular dysfunction observed, but not linked to onchocerciasis.
- No evidence found for immune-mediated glomerular disorders in hyperreactive onchocerciasis.
- Ivermectin treatment led to slight, temporary increases in urinary albumin and alpha1-microglobulin, particularly in patients with high microfilarial loads.
Conclusions:
- No association between onchocerciasis and renal abnormalities was detected in this cohort.
- Ivermectin treatment can cause minor, transient glomerular and tubular disturbances.
- These ivermectin-induced renal changes appear to be clinically insignificant.