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Renal Involvement in Leprosy.

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    Leprosy patients, particularly lepromatous leprosy (LL) cases, frequently show kidney damage. Renal biopsies revealed chronic glomerulonephritis and other inflammatory changes, but surprisingly, no leprosy-specific granulomas were found in the kidneys.

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    Area of Science:

    • Nephrology
    • Infectious Diseases
    • Pathology

    Background:

    • Leprosy, a chronic infectious disease, can affect various organs, including the kidneys.
    • Understanding the spectrum and pathology of renal involvement in leprosy is crucial for patient management.

    Purpose of the Study:

    • To assess the extent and nature of renal involvement in lepromatous leprosy (LL) and non-lepromatous leprosy patients.
    • To correlate clinical, biochemical, and histopathological findings of kidney disease in leprosy.

    Main Methods:

    • Evaluated 20 LL patients, 5 non-lepromatous leprosy patients, and 10 healthy controls.
    • Utilized biochemical blood and urine analysis, renal functional tests, and renal biopsy histopathology.
    • Assessed parameters like albumin/globulin ratio and creatinine clearance.

    Main Results:

    • LL patients exhibited varying degrees of renal involvement, including abnormal urine sediment and altered protein levels.
    • Renal biopsies showed significant histopathological lesions in 50% of LL patients versus 20% of non-lepromatous patients.
    • Predominant pathological findings included chronic glomerulonephritis, chronic pyelonephritis, and interstitial nephritis, with no granulomas, acid-fast bacilli, or amyloid observed.

    Conclusions:

    • Renal involvement is common in lepromatous leprosy, manifesting as chronic inflammatory and degenerative changes.
    • Histopathological examination is key to identifying renal pathology, which predominantly involves chronic glomerulonephritis.
    • The absence of granulomas or specific leprosy markers in renal biopsies suggests indirect mechanisms of kidney damage.