- Review Article
- Published: 28 March 2022
- Elizabeth De Francesco Daher,
- Geraldo Bezerra da Silva Junior,
- Mayuri Trivedi,
- Tarek Fayad,
- Nattachai Srisawat,
- Sanjeev Nair,
- Padet Siriyasatien,
- Marcus Vinícius Guimarães de Lacerda,
- Maria Alice Sperto Ferreira Baptista,
- Mahesha Vankalakunti &
- Vivekanand Jha
Nature Reviews Nephrology volume 18, pages396–406 (2022)Cite this article
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Abstract
Parasitic agents have been known to cause human disease since ancient times and are endemic in tropical and subtropical regions. Complications of parasitic diseases, including kidney involvement, are associated with worse outcomes. Chagas disease, filariasis, leishmaniasis, malaria and schistosomiasis are important parasitic diseases that can damage the kidney. These diseases affect millions of people worldwide, primarily in Africa, Asia and Latin America, and kidney involvement is associated with increased mortality. The most common kidney complications of parasitic diseases are acute kidney injury, glomerulonephritis and tubular dysfunction. The mechanisms that underlie parasitic disease-associated kidney injury include direct parasite damage; immunological phenomena, including immune complex deposition and inflammation; and systemic manifestations such as haemolysis, haemorrhage and rhabdomyolysis. In addition, use of nephrotoxic drugs to treat parasitic infections is associated with acute kidney injury. Early diagnosis of kidney involvement and adequate management is crucial to prevent progression of kidney disease and optimize patient recovery.
Key points
Parasitic diseases are a major public health problem worldwide and are associated with multiple complications, including kidney injury.
The highest incidence of parasitic diseases is in tropical regions; however, they are increasingly observed in high-income countries, mainly among immigrant populations.
Kidney involvement is common in Chagas disease, filariasis, leishmaniasis, malaria and schistosomiasis.
Kidney injury in these diseases is mediated by immunological phenomena, systemic manifestations of the parasitic infection, direct damage caused by the parasites and use of nephrotoxic medications.
Acute kidney injury, glomerulonephritis and tubular dysfunction are the most frequently observed kidney abnormalities in patients with parasitic diseases.
Early detection of kidney impairment in these patients is essential to enable adequate management and prevent progression to chronic kidney disease and/or kidney failure.
Source: https://www.nature.com/articles/s41581-022-00558-z