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Visceral Leishmaniasis (Kala-Azar) Nephropathy

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Tropical Nephrology

Abstract

Visceral leishmaniasis (VL) (kala-azar) is a parasitic disease caused by Leishmania that affects thousands of people worldwide. Renal impairment in VL is important and frequent. Acute kidney injury (AKI) affects 46% of hospitalized patients and is associated with increased mortality. Risk factors observed for AKI include hypokalemia, leukopenia, and amphotericin B use. Other important kidney abnormalities in visceral leishmaniasis include interstitial nephritis and glomerulonephritis. Clinical manifestations include moderate proteinuria, hematuria, leukocyturia, microalbuminuria, hydroelectrolytic disturbances such as hyponatremia, hypokalemia, hypocalcemia, hypomagnesemia, increased excretion fraction of various electrolytes, and defects in urinary concentration and acidification. Glomerulonephritis in visceral leishmaniasis is characterized by mesangial proliferative pattern and can evolve to rapidly progressive disease. Specific treatment is associated with renal function improvement, but partial recovery is observed in a significant percentage of patients.

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Authors and Affiliations

  1. Department of Internal Medicine, Post-Graduation Program in Medical Sciences, Federal University of Ceara, Fortaleza, Ceara, Brazil

    Gdayllon Cavalcante Meneses

  2. Department of Community Health, Federal University of Ceara, Fortaleza, Ceara, Brazil

    Guilherme Alves de Lima Henn

  3. Department of Clinical and Toxicological Analyses, Post-Graduation Program in Pharmaceutical Sciences, Federal University of Ceara, Fortaleza, Ceara, Brazil

    Alice Maria Costa Martins

  4. School of Medicine, Federal University of Alagoas, Maceio, Alagoas, Brazil

    Michelle Jacintha Cavalcante Oliveira

  5. Post-Graduation Program in Medical Sciences, School of Medicine, Federal University of Ceara, Fortaleza, Ceara, Brazil

    Elizabeth De Francesco Daher

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  1. Gdayllon Cavalcante Meneses
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  3. Alice Maria Costa Martins
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  1. University of Fortaleza, Fortaleza, Ceará, Brazil

    Geraldo Bezerra da Silva Junior

  2. Federal University of Ceará, Fortaleza, Ceará, Brazil

    Elizabeth De Francesco Daher

  3. Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil

    Elvino Barros

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Meneses, G.C., de Lima Henn, G.A., Martins, A.M.C., Oliveira, M.J.C., De Francesco Daher, E. (2020). Visceral Leishmaniasis (Kala-Azar) Nephropathy. In: Bezerra da Silva Junior, G., De Francesco Daher, E., Barros, E. (eds) Tropical Nephrology. Springer, Cham. https://doi.org/10.1007/978-3-030-44500-3_19

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  • DOI: https://doi.org/10.1007/978-3-030-44500-3_19

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