Renal function evaluation in patients with American cutaneous leishmaniasis after specific treatment with pentavalent antimonial

BMC Nephrol. 2012 Jun 20:13:44. doi: 10.1186/1471-2369-13-44.

Abstract

Background: Renal evaluation studies are rare in American Cutaneous Leishmaniasis (ACL). The aim of this study is to investigate whether specific treatment reverts ACL-associated renal dysfunction.

Methods: A prospective study was conducted with 37 patients with ACL. Urinary concentrating and acidification ability was assessed before and after treatment with pentavalent antimonial.

Results: The patients mean age was 35.6 ± 12 years and 19 were male. Before treatment, urinary concentrating defect (U/Posm <2.8) was identified in 27 patients (77%) and urinary acidification defect in 17 patients (46%). No significant glomerular dysfunction was observed before and after specific ACL treatment. There was no reversion of urinary concentrating defects, being observed in 77% of the patients before and in 88% after treatment (p = 0.344). Urinary acidification defect was corrected in 9 patients after treatment, reducing its prevalence from 40% before to only 16% after treament, (p = 0.012). Microalbuminuria higher than 30 mg/g was found in 35% of patients before treatment and in only 8% after treatment. Regarding fractional excretion of sodium, potassium, calcium, phosphorus and magnesium, there was no significant difference between pre and post-treatment period.

Conclusion: As previously described, urinary concentrating and acidification defects were found in an important number of patients with ACL. Present results demonstrate that only some patients recover urinary acidification capacity, while no one returned to normal urinary concentration capacity.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antiprotozoal Agents / pharmacology
  • Antiprotozoal Agents / therapeutic use*
  • Female
  • Humans
  • Kidney / drug effects
  • Kidney / physiology*
  • Kidney Diseases / diagnosis
  • Kidney Diseases / physiopathology
  • Kidney Diseases / urine
  • Leishmaniasis, Cutaneous / drug therapy*
  • Leishmaniasis, Cutaneous / physiopathology
  • Leishmaniasis, Cutaneous / urine
  • Male
  • Meglumine / pharmacology
  • Meglumine / therapeutic use*
  • Meglumine Antimoniate
  • Middle Aged
  • Organometallic Compounds / pharmacology
  • Organometallic Compounds / therapeutic use*
  • Prospective Studies
  • Treatment Outcome
  • Young Adult

Substances

  • Antiprotozoal Agents
  • Organometallic Compounds
  • Meglumine
  • Meglumine Antimoniate