Preliminary study on tubuloglomerular dysfunction and evidence of renal inflammation in patients with visceral leishmaniasis

Am J Trop Med Hyg. 2014 Nov;91(5):908-11. doi: 10.4269/ajtmh.14-0167. Epub 2014 Aug 11.

Abstract

Visceral leishmaniasis (VL) is a re-emerging zoonosis of worldwide distribution. Monocyte chemotactic protein-1 (MCP-1) and malondialdehyde (MDA) are inflammation biomarkers that have never been investigated in VL. The aim of this study is to investigate the association between renal abnormalities and inflammation biomarkers in VL. This study is a preliminary prospective study with 16 VL adult patients evaluated before treatment compared with a group of 13 healthy volunteers and 5 VL patients evaluated after treatment. Urinary concentration and acidification tests were performed. MCP-1 and MDA were quantified in urine. Urinary concentration deficit was found in all VL patients before (100%) and four VL patients after (80%) treatment. Urinary acidification deficit was found in nine cases before (56.2%) and two cases after (40%) treatment. Urinary MCP-1 (374 ± 359 versus 42 ± 29 pg/mg creatinine, P = 0.002) as well as urinary MDA (5.4 ± 2.6 versus 2.0 ± 0.8 μmol/mL) showed significant differences between VL patients and controls. These data show that VL patients present urinary concentration and acidification deficit, which can persist even after specific treatment. Urinary MCP-1 and MDA are elevated in patients with VL, which suggests renal inflammation and incipient renal damage.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antiprotozoal Agents / therapeutic use
  • Biomarkers / urine*
  • Case-Control Studies
  • Chemokine CCL2 / urine
  • Female
  • Humans
  • Inflammation / complications
  • Inflammation / parasitology
  • Inflammation / urine*
  • Kidney / physiopathology
  • Kidney Diseases / complications*
  • Kidney Diseases / parasitology
  • Leishmaniasis, Visceral / complications
  • Leishmaniasis, Visceral / drug therapy
  • Leishmaniasis, Visceral / urine*
  • Male
  • Malondialdehyde / urine
  • Meglumine / therapeutic use
  • Meglumine Antimoniate
  • Middle Aged
  • Organometallic Compounds / therapeutic use
  • Prospective Studies
  • Young Adult

Substances

  • Antiprotozoal Agents
  • Biomarkers
  • CCL2 protein, human
  • Chemokine CCL2
  • Organometallic Compounds
  • Malondialdehyde
  • Meglumine
  • Meglumine Antimoniate