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Daily urinary protein loss in Schistosoma haematobium infection
Insights
Urinary schistosomiasis in children significantly increases protein loss. Despite high proteinuria, serum protein levels remained normal, suggesting adaptive mechanisms in patients with Schistosoma haematobium infection.
Area of Science:
- Tropical Medicine
- Parasitology
- Nephrology
Background:
- Schistosoma haematobium infection is a major public health concern in endemic areas.
- Proteinuria is a common complication of urinary schistosomiasis.
- Understanding the extent and implications of proteinuria in pediatric schistosomiasis is crucial for effective management.
Purpose of the Study:
- To investigate the prevalence and severity of proteinuria in children infected with Schistosoma haematobium.
- To determine the correlation between Schistosoma haematobium egg excretion and urinary protein loss.
- To assess serum protein and albumin levels in infected children with significant proteinuria.
Main Methods:
- A cross-sectional study involving 128 children aged 6-18 years with Schistosoma haematobium infection.
- Collection of spontaneously voided midday urine and 24-hour urine specimens for protein concentration analysis.
- Correlation analysis between urinary egg counts and protein loss, as well as measurement of total serum protein and albumin.
Main Results:
- Urinary protein concentration was significantly higher in midday samples from heavily infected patients (>100 ova/10 ml).
- Median daily urinary protein loss was 300 mg in moderate infections and 584 mg/1.73 m2 in heavy infections.
- Significant correlations were found between egg excretion and both protein concentration and daily protein loss (r=0.76 and r=0.68).
- Despite daily protein loss up to 3.3 g/1.73 m2, serum protein and albumin remained within normal limits.
Conclusions:
- Children with Schistosoma haematobium infection exhibit significant proteinuria, directly related to infection intensity.
- Normal serum protein and albumin levels in heavily proteinuric patients suggest potential adaptive mechanisms to maintain homeostasis.
- Further research is warranted to elucidate these adaptive mechanisms in urinary schistosomiasis.
Abstract:
Proteinuria was studied in 128 children aged 6 to 18 years with Schistosoma haematobium infection in the People's Republic of Congo. Urinary protein concentration in spontaneously voided midday urine of patients with greater than 100 ova/10 ml was significantly higher than in 24-hr urine specimens. Median daily urinary protein loss in patients with moderate intensity of infection (100-350 ova/10 ml) was 300 mg and 584 mg/1.73 m2 body surface in heavily infected patients (greater than 350 ova/10 ml). A significant correlation existed between egg excretion at noon and protein concentration in spontaneous urine samples as well as daily urinary protein loss (r = 0.76 and r = 0.68, respectively). Heavily infected patients had a daily protein loss of up to 3.3 g/1.73 m2, total serum protein and albumin concentration, however, were within normal limits. This may indicate adaptive mechanisms in patients with urinary schistosomiasis and high proteinuria which maintain a balanced serum protein concentration.