Renal function in Sudanese school children with Schistosoma mansoni infection

Renal function was investigated in 218 school children with Schistosoma mansoni infection in the Providence of Gezira in central Sudan and in 65 Sudanese and 65 German age-matched controls. Serum creatinine was normal in all children. A pathological urinary protein-creatinine ratio was found in 3% of S. mansoni-infected children and in 5% of Sudanese controls but in none of the European children. Characterization of pathological proteinuria using albumin nephelometry, alpha-1 microglobulin immunodiffusion and SDS-polyacrylamide gel electrophoresis in these children showed glomerular, tubular or mixed glomerulotubular patterns. One, 4 and 6 months following treatment of schistosomiasis with praziquantel, stools were re-examined; 57% of patients were cured, 16% were found to be reinfected and 27% had persistent egg excretion. Six months after therapy, pathological urinary protein-creatinine ratios were encountered in 3% of S. mansoni patients and in none of the 34 reinvestigated controls. Proteinuria was similar in patients with persistent S. mansoni egg excretion and in children cured of schistosomiasis infection. It is concluded that there was no evidence for S. mansoni associated glomerulonephritis in this group of Sudanese children. The high rate of pathological proteinuria in S. mansoni-infected and non-infected Sudanese children may be due to other causes.