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Surrogate markers of subtle renal injury in patients with visceral leishmaniasis

N A A Elnojomi1, A M Musa, B M Younis

  • 1The Leishmaniasis Research Group/Sudan, The Institute of Endemic Diseases, University of Khartoum, Khartoum, Sudan.

Saudi Journal of Kidney Diseases and Transplantation : an Official Publication of the Saudi Center for Organ Transplantation, Saudi Arabia
|September 4, 2010
PubMed

Insights

Subtle kidney damage in Sudanese visceral leishmaniasis (VL) primarily affects the glomeruli, as indicated by microalbuminuria (MA). Turbidometry is a reliable, cost-effective method for detecting MA in VL patients.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Pediatrics

Background:

  • Sudanese visceral leishmaniasis (VL) is a significant pediatric disease causing fever, enlarged organs, swollen lymph nodes, low blood counts, and kidney damage.
  • Microalbuminuria (MA) and urinary retinol binding protein (urRBP) are key indicators of glomerular and tubular kidney dysfunction, respectively.

Purpose of the Study:

  • To determine the prevalence of subtle renal injury in children with Sudanese VL.
  • To evaluate the diagnostic utility of microalbuminuria (MA) and urinary retinol binding protein (urRBP) as markers for renal dysfunction in VL patients.

Main Methods:

  • A cross-sectional study involving 88 parasitologically confirmed VL patients before treatment.
  • Analysis of blood and urine samples for hematological and biochemical profiles, including MA and urRBP measurement using ELISA and immunoturbidometry.

Main Results:

  • All patients exhibited normal serum urea and creatinine levels, with no detectable urRBP.
  • Microalbuminuria (MA) was detected in 40% of patients by ELISA and 42% by turbidometry.
  • The MA turbidometric technique demonstrated high sensitivity (100%), specificity (96%), and predictive values (95% positive, 100% negative).

Conclusions:

  • Subtle renal injury in Sudanese VL is predominantly glomerular.
  • Turbidometry is a simple, cost-effective, sensitive, and specific method for measuring MA in VL, offering high predictive values for diagnosing glomerular injury.

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