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Renal Alterations Secondary to Visceral Leishmaniasis: A Scoping Review
João Victor Corrêa E Silva1, Lethícia de Oliveira Carvalho1, Luiz Henrique da Silva1
1Universidade Federal de Alagoas, Departamento de Medicina, Arapiraca, AL, Brasil.
Background:
Visceral leishmaniasis (VL) is an endemic and neglected disease in several countries. In addition to affecting the visceral tissues, kidney alterations are recurrent and result from the pathophysiological implications of infection or drug action during treatment. This review mapped and described renal changes, renal biomarkers, and treatment-related nephrotoxicity in humans with confirmed VL.
Methods:
This scoping review was conducted in accordance with the Joanna Briggs Institute Manual for Evidence Synthesis and the PRISMA-ScR guidelines. PubMed, SciELO, ScienceDirect, Scopus, and Web of Science. were searched with no temporal or geographical restrictions. We included studies involving humans with confirmed VL that reported renal alterations, kidney injury biomarkers, or treatment-related nephrotoxicity. Two reviewers independently screened the records and extracted data. Study selection was documented using the PRISMA-ScR flowchart.
Results:
In total, 1,444 studies were identified, of which 15 met the eligibility criteria. The included studies reported a wide spectrum of renal alterations in VL, including urinary abnormalities, kidney injury biomarkers, and acute kidney injury. Glomerular and tubulointerstitial changes, such as mesangial alterations, membranoproliferative patterns, cryoglobulinemia, interstitial nephritis, and impaired urinary concentrating ability, have also been described. Reports have also addressed the potential treatment-related nephrotoxicity.
Conclusion:
This scoping review identified diverse renal alterations in patients with VL, ranging from functional changes and urinary abnormalities to glomerular and tubulointerstitial involvement. Evidence has also described biomarkers of kidney injury and potential treatment-related nephrotoxicity. The heterogeneity and limited data highlight the need for robust research to clarify the underlying mechanisms, diagnostic markers, and optimal management.
Insights
Visceral leishmaniasis (VL) causes diverse kidney problems, including functional changes and acute kidney injury. Further research is needed to understand mechanisms and improve management of these renal alterations in VL patients.
Area of Science:
- Nephrology
- Infectious Diseases
- Parasitology
Background:
- Visceral leishmaniasis (VL) is a neglected tropical disease with endemicity in several regions.
- Kidney alterations are common in VL, stemming from infection or treatment side effects.
- Understanding renal involvement is crucial for patient management and therapeutic strategies.
Purpose of the Study:
- To systematically map and describe renal changes in human VL patients.
- To identify reported renal biomarkers associated with VL.
- To review treatment-related nephrotoxicity in the context of VL.
Main Methods:
- A scoping review was performed following Joanna Briggs Institute and PRISMA-ScR guidelines.
- Searches were conducted across major databases (PubMed, SciELO, Scopus, Web of Science) without restrictions.
- Studies reporting renal alterations, biomarkers, or nephrotoxicity in confirmed VL patients were included.
Main Results:
- Fifteen studies met eligibility criteria, revealing a wide spectrum of renal alterations in VL.
- Findings include urinary abnormalities, acute kidney injury, glomerular, and tubulointerstitial changes.
- Potential treatment-related nephrotoxicity was also documented.
Conclusions:
- VL is associated with diverse renal manifestations, from functional changes to structural kidney damage.
- Biomarkers for kidney injury and nephrotoxicity are reported, but data is limited.
- Further research is essential to elucidate mechanisms, refine diagnostics, and optimize VL treatment strategies.
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