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Infections and the kidney: a tale from the tropics

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Abstract

Tropical infections are caused by a variety of bacteria, viruses and parasitic organisms across varying geographical regions and are more often reported in adults than in children. Most of the infections are acute, presenting as a febrile illness with involvement of multiple organ systems, including the kidney. The gamut of renal manifestations extends from asymptomatic urinary abnormalities to acute kidney injury and—albeit rarely—chronic kidney disease. Tropical infections can involve the glomerular, tubulointerstitial and vascular compartments of the kidney. Leptospirosis, malaria, dengue, rickettsial fever and schistosomiasis are the most prevalent tropical infections which affect the kidneys of children living in the tropics. In this review we discuss renal involvement in these most prevalent tropical infections.

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References

  1. Thuraisingham RC, Adu D (2014) Renal diseases in the tropics. Manson's tropical diseases, 23rd edn. Elsevier, Saunders, pp 933–951

    Google Scholar 

  2. Cerdá J, Lameire N, Eggers P, Pannu N, Uchino S, Wang H, Bagga A, Levin A (2008) Epidemiology of acute kidney injury. Clin J Am Soc Nephrol 3:881–886

    Article  PubMed  Google Scholar 

  3. Lameire N, van Biesen W, Vanholder R (2016) Epidemiology of acute kidney injury in children worldwide, including developing countries. Pediatr Nephrol:1–14

  4. Olowu WA, Niang A, Osafo C, Ashuntantang G, Arogundade FA, Porter J, Naicker S, Luyckx VA (2016) Outcomes of acute kidney injury in children and adults in sub-Saharan Africa: a systematic review. Lancet Glob Health 4:e242–e250

    Article  PubMed  Google Scholar 

  5. Jha V, Chugh KS (2008) Community-acquired acute kidney injury in Asia. Semin Nephrol 28:330–347

    Article  PubMed  Google Scholar 

  6. Daher EDF, da Silva Junior GB, Vieira APF, de Souza JB, Falcao FDS, da Costa CR, da Silva Fernandes AAC, Lima RSA (2014) Acute kidney injury in a tropical country: a cohort study of 253 patients in an infectious diseases intensive care unit. Rev Soc Bras Med Trop 47:86–89

    Article  Google Scholar 

  7. Naicker S, Aboud O, Gharbi MB (2008) Epidemiology of acute kidney injury in Africa. Semin Nephrol 28:348–353

    Article  PubMed  Google Scholar 

  8. Basu G, Chrispal A, Boorugu H, Gopinath KG, Chandy S, Prakash JAJ, Thomas K, Abraham AM, John GT (2011) Acute kidney injury in tropical acute febrile illness in a tertiary care centre RIFLE criteria validation. Nephrol Dial Transplant 26:524–531

    Article  PubMed  Google Scholar 

  9. Kumar V, Kumar V, Yadav AK, Iyengar S, Bhalla A, Sharma N, Aggarwal R, Jain S, Jha V (2014) Scrub typhus is an under-recognized cause of acute febrile illness with acute kidney injury in India. PLoS Negl Trop Dis 8:e2605

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  10. Krishnamurthy S, Mondal N, Naraysanan P, Biswal N, Srinivasan S, Soundravally R (2013) Incidence and etiology of acute kidney injury in southern India. Indian J Pediatr 80:183–189

    Article  PubMed  Google Scholar 

  11. Singh A, Seth R, Singla M, Kabra SK, Lodha R (2017) Clinical profile of dengue infection in immune-compromised children. Indian Pediatr 54:244–246

    Google Scholar 

  12. Jha V, Prasad N (2016) CKD and infectious diseases in Asia Pacific: challenges and opportunities. Am J Kidney Dis 68:148–160

    Article  PubMed  Google Scholar 

  13. Basu G (2015) Infections after kidney transplantation: the bug bear of kidney transplantation in tropics. Open Urol Nephrol J 8:76–87

    Article  Google Scholar 

  14. Barsoum RS (2006) Chronic kidney disease in the developing world. N Engl J Med 354:997–999

    Article  PubMed  CAS  Google Scholar 

  15. Barsoum RS, Francis MR, Sitprija V (1999) Renal involvement in tropical disease. In: Schrier RW (ed) Atlas of diseases of the kidney, 1st edn. Blackwell Science, Philadelphia, pp 6–18. http://citeseerx.ist.psu.edu

  16. Sitprija V (1988) Nephropathy in falciparum malaria. Kidney Int 34:867–877

    Article  PubMed  CAS  Google Scholar 

  17. Sobh M, Moustafa F, El-Arbagy A, El-Din MS, Amer G (1990) Nephropathy in asymptomatic patients with active Schistosoma mansoni infection. Int Urol Nephrol 22:37–43

  18. Hendrickse RG, Adeniyi A (1979) Quartan malarial nephrotic syndrome in children. Kidney Int 16:64–74

    Article  PubMed  CAS  Google Scholar 

  19. Waugh DA, Alexander JH, Ibels LS (1980) Filarial chyluria associated glomerulonephritis and therapeutic considerations in the Chyluric patient. Aust NZ J Med 10:559–562

  20. Sitprija V, Keoplung M, Boonpucknavig V, Boonpucknavig S (1980) Renal involvement in human trichinosis. Arch Intern Med 140:544–546

    Article  PubMed  CAS  Google Scholar 

  21. da Silva Junior GB, Guardão Barros EJ, De Francesco DE (2014) Kidney involvement in leishmaniasis—a review. Braz J Infect Dis 18:434–440

    Article  PubMed  Google Scholar 

  22. Andrade L, de Francesco DE, Seguro AC (2008) Leptospiral nephropathy. Semin Nephrol 28:383–394

    Article  PubMed  CAS  Google Scholar 

  23. Visith S, Kearkiat P (2005) Nephropathy in leptospirosis. J Postgrad Med 51:184–188

    PubMed  CAS  Google Scholar 

  24. Bharti AR, Nally JE, Ricaldi JN, Matthias MA, Diaz MM, Lovett MA, Levett PN, Gilman RH, Willig MR, Gotuzzo E, Vinetz JM (2003) Leptospirosis: a zoonotic disease of global importance. Lancet Infect Dis 3:757–771

    Article  PubMed  Google Scholar 

  25. Agampodi SB, Peacock SJ, Thevanesam V, Nugegoda DB, Smythe L, Thaipadungapanit J, Craig SB, Burns MA, Dohnt M, Boonsilp S, Senaratne T, Kumara A, Palihawadana P, Perera S, Vinetz JM (2011) Leptospirosis outbreak in Sri Lanka in 2008: lessons for assessing the global burden of disease. Am J Trop Med Hyg 85:471–478

    Article  PubMed  PubMed Central  Google Scholar 

  26. Sethi S, Sharma N, Kakkar N, Taneja J, Chatterjee SS, Banga SS, Sharma M (2010) Increasing trends of leptospirosis in northern India: a clinico-epidemiological study. PLoS Negl Trop Dis 4:1–7

    Article  Google Scholar 

  27. Daher EDF, de Abreu KLS, da Silva Junior GB (2010) Leptospirosis-associated acute kidney injury. J Bras Nefrol 32:400–407

    Article  Google Scholar 

  28. Nair JJ, Bhat A, Prabhu MV (2016) A clinical study of acute kidney injury in tropical acute febrile illness. J Clin Diagn Res 10:OC01–OC05

    PubMed  PubMed Central  Google Scholar 

  29. Wongsrichanalai C, Murray CK, Gray M, Miller RS, McDaniel P, Liao WJ, Pickard AL, Magill A (2003) Co-infection with malaria and leptospirosis. Am J Trop Med Hyg 68:583–585

    Article  PubMed  Google Scholar 

  30. Sunil-Chandra NP, Clement J, Maes P, DeSilva HJ, Van Esbroeck M, Van Ranst M (2015) Concomitant leptospirosis-hantavirus co-infection in acute patients hospitalized in Sri Lanka: implications for a potentially worldwide underestimated problem. Epidemiol Infect 143:2081–2093

    Article  PubMed  CAS  Google Scholar 

  31. Abdulkader RCRM, Silva MV (2008) The kidney in leptospirosis. Pediatr Nephrol 23:2111–2120

    Article  PubMed  Google Scholar 

  32. Marotto PC, Marotto MS, Santos DL, Souza TN, Seguro AC (1997) Outcome of leptospirosis in children. Am J Trop Med Hyg 56:307–310

    Article  PubMed  CAS  Google Scholar 

  33. Anacleto FE, Collado AB, Wyson AM (2014) Profile of acute kidney injury in pediatric leptospirosis. Ren Fail 36:1090–1094

    Article  PubMed  CAS  Google Scholar 

  34. Haake DA, Levett PN (2015) Leptospirosis in humans. Curr Top Microbiol Immunol 387:65–97

    PubMed  PubMed Central  CAS  Google Scholar 

  35. Herath NJ, Kularatne SAM, Weerakoon KGAD, Wazil A, Subasinghe N, Ratnatunga N (2014) Long term outcome of acute kidney injury due to leptospirosis: a longitudinal study in Sri Lanka. BMC Res Notes 7:398

    Article  PubMed  PubMed Central  Google Scholar 

  36. Wiwanitkit V (2006) Comparison between blood exchange and classical therapy for acute renal failure in Weil’s disease: appraisal on Thai reports. Nephrology 11:481

    Article  PubMed  Google Scholar 

  37. Costa F, Hagan JE, Calcagno J, Kane M, Torgerson P, Martinez-Silveira MS, Stein C, Abela-Ridder B, Ko AI (2015) Global morbidity and mortality of Leptospirosis: a systematic review. PLoS Negl Trop Dis 9:e0003898

    Article  PubMed  PubMed Central  Google Scholar 

  38. Mahajan SK (2012) Rickettsial diseases. J Assoc Physicians India 60:37–44

    PubMed  Google Scholar 

  39. Rathi N, Kulkarni A, Yewale V, For Indian Academy of Pediatrics Guidelines on Rickettsial Diseases in Children Committee (2017) IAP guidelines on Rickettsial diseases in children. Indian Pediatr 54:223–229

    Article  PubMed  Google Scholar 

  40. Gikas A, Kokkini S, Tsioutis C (2010) Q fever: clinical manifestations and treatment. Expert Rev Anti-Infect Ther 8:529–539

    Article  PubMed  Google Scholar 

  41. Alvarez-Hernandez G, Murillo-Benitez C, Candia-Plata Mdel C, Moro M (2015) Clinical profile and predictors of fatal Rocky Mountain spotted fever in children from Sonora, Mexico. Pediatr Infect Dis J 34:125–130

    Article  PubMed  Google Scholar 

  42. Woods CR (2013) Rocky Mountain spotted fever in children. Pediatr Clin North Am 60:455–470

    Article  PubMed  Google Scholar 

  43. Jensenius M, Fournier P-E, Raoult D (2004) Rickettsioses and the international traveler. Clin Infect Dis 39:1493–1499

    Article  PubMed  Google Scholar 

  44. Cowan G (2000) Rickettsial diseases: the typhus group of fevers—a review. Postgrad Med J 76:269–272

  45. Lima EQ, Nogueira ML (2008) Viral hemorrhagic fever-induced acute kidney injury. Semin Nephrol 28:409–415

    Article  PubMed  Google Scholar 

  46. World Health Organization (2011) Prevention and control of dengue and dengue haemorrhagic fever. Available from: http://www.searo.who.int/entity/vector_borne_tropical_diseases/documents/SEAROTPS60/en/

  47. World Health Organization (2015) National guidelines for clinical management of dengue fever. Available from: www.pbhealth.gov.in/Dengue-National-Guidelines-2014%20Compressed.pdf

  48. Vachvanichsanong P, Thisyakorn U, Thisyakorn C (2016) Dengue hemorrhagic fever and the kidney. Arch Virol 161:771–778

    Article  PubMed  CAS  Google Scholar 

  49. Laoprasopwattana K, Pruekprasert P, Dissaneewate P, Geater A, Vachvanichsanong P (2010) Outcome of dengue hemorrhagic fever-caused acute kidney injury in Thai children. J Pediatr 157:303–309

    Article  PubMed  Google Scholar 

  50. Lee IK, Liu JW, Yang KD (2009) Clinical characteristics, risk factors, and outcomes in adults experiencing dengue hemorrhagic fever complicated with acute renal failure. Am J Trop Med Hyg 80:651–655

    Article  PubMed  Google Scholar 

  51. Lizarraga KJ, Nayer A (2014) Dengue-associated kidney disease. J Nephropathol 3:57–62

    PubMed  Google Scholar 

  52. Khalil MAM, Sarwar S, Chaudry MA, Maqbool B, Khalil Z, Tan J, Yaqub S, Hussain SA (2012) Acute kidney injury in dengue virus infection. Clin Kidney J 5:390–394

    Article  PubMed  PubMed Central  Google Scholar 

  53. Picollo Oliveira JF, Burdmann EA (2015) Dengue-associated acute kidney injury. Clin Kidney J 8:681–685

    Article  CAS  Google Scholar 

  54. Mallhi TH, Khan AH, Adnan AS, Sarriff A, Khan YH, Jummaat F (2015) Incidence, characteristics and risk factors of acute kidney injury among dengue patients: a retrospective analysis. PLoS One 10:e0138465

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  55. Ferluga D, Vizjak A (2008) Hantavirus nephropathy. J Am Soc Nephrol 19:1653–1658

    Article  PubMed  CAS  Google Scholar 

  56. Latus J, Schwab M, Tacconelli E, Pieper FM, Wegener D, Rettenmaier B, Schwab A, Hoffmann L, Dippon J, Muller S, Fritz P, Zakim D, Segerer S, Kitterer D, Kimmel M, Gumann K, Priwitzer M, Mezger B, Walter-Frank B, Corea A, Wiedenmann A, Brockmann S, Pohlmann C, Alscher MD, Braun N (2015) Acute kidney injury and tools for risk-stratification in 456 patients with hantavirus-induced nephropathia epidemica. Nephrol Dial Transplant 30:245–251

    Article  PubMed  CAS  Google Scholar 

  57. Mustonen J, Huttunen N, Vaheri A (1994) Clinical picture of nephropathia epidemica in children. Acta Paediatr 83:526–529

    Article  PubMed  CAS  Google Scholar 

  58. Faulde M, Sobe D, Kimmig P, Scharninghausen J (2000) Renal failure and hantavirus infection in Europe. Nephrol Dial Transplant 15:751–753

    Article  PubMed  CAS  Google Scholar 

  59. World Health Organization (2015) World malaria report 2015. Available from: http://www.who.int/malaria/publications/world-malaria-report-2015/report/

  60. Mishra SK, Das BS (2008) Malaria and acute kidney injury. Semin Nephrol 28:395–408

    Article  PubMed  CAS  Google Scholar 

  61. Ehrich JHH, Eke FU (2007) Malaria-induced renal damage: facts and myths. Pediatr Nephrol 22:626–637

    Article  PubMed  Google Scholar 

  62. Das BS (2008) Renal failure in malaria. J Vector Borne Dis 45:83–97

    PubMed  CAS  Google Scholar 

  63. Padhi RK, Mishra S (2013) Incidence of renal involvement in malaria in children of odisha. ISRN Nephrol 2013:573735

    Article  PubMed  Google Scholar 

  64. Ahmad SH, Danish T, Faridi MM, Ahmad FAJ, Fakhir S, Khan AS (1989) Renal function in acute malaria in children. J Trop Pediatr 35:291–294

    Article  PubMed  CAS  Google Scholar 

  65. Zaki SA, Shenoy P, Shanbag P, Mauskar A, Patil A, Nagotkar L (2013) Acute renal failure associated with malaria in children. Saudi J Kidney Dis Transpl 24:303–308

    Article  PubMed  Google Scholar 

  66. Ajetunmobi WA, Orimadegun AE, Brown BJ, Afolabi NK, Olabiyi FA, Anetor JI, Omokhodion S, Osinusi K, Akinbami FO, Shokunbi WA, Sodeinde O, Fernandez-Reyes D (2012) Haemoglobinuria among children with severe malaria attending tertiary care in Ibadan, Nigeria. Malar J 11:336

    Article  PubMed  PubMed Central  Google Scholar 

  67. Sowunmi A (1996) Renal function in acute falciparum malaria. Arch Dis Child 74:293–298

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  68. Burchard GD, Ehrhardt S, Mockenhaupt FP, Mathieu A, Agana-Nsiire P, Anemana SD, Otchwemah RN, Abel W, Brattig N (2003) Renal dysfunction in children with uncomplicated, plasmodium falciparum malaria in tamale, Ghana. Ann Trop Med Parasitol 97:345–350

    Article  PubMed  CAS  Google Scholar 

  69. Weber MW, Zimmermann U, Van Hensbroek MB, Frenkel J, Palmer A, Ehrich JHH, Greenwood BM (1999) Renal involvement in Gambian children with cerebral or mild malaria. Trop Med Int Health 4:390–394

    Article  PubMed  CAS  Google Scholar 

  70. World Health Organization (2015) Guidelines for the treatment of malaria, third edn. http://www.who.int/malaria/publications/atoz/9789241549127/

  71. Mishra SKMK (2012) Peritoneal dialysis in patietns with malaria and acute kidney injury. Perit Dial Int 32:656–659

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  72. Mishra NR, Panda PC, Nayak SR (2016) Effect of peritoneal dialysis on malarial AKI children: a cross sectional study. Int J Med Paediatr Oncol 2:46

    Article  Google Scholar 

  73. Sheiban AK (1999) Prognosis of malaria associated severe acute renal failure in children. Ren Fail 21:63–66

    Article  PubMed  CAS  Google Scholar 

  74. Olowu WA, Adelusola KA, Adefehinti O, Oyetunji TG (2010) Quartan malaria-associated childhood nephrotic syndrome: now a rare clinical entity in malaria endemic Nigeria. Nephrol Dial Transplant 25:794–801

    Article  PubMed  Google Scholar 

  75. da Silva GB, Duarte DB, Barros EJG, De Francesco DE (2013) Schistosomiasis-associated kidney disease: a review. Asian Pac J Trop Dis 3:79–84

    Article  Google Scholar 

  76. Gryseels B, Polman K, Clerinx J, Kestens L (2006) Human schistosomiasis. Lancet 368:1106–1118

    Article  PubMed  Google Scholar 

  77. Barsoum RS (1993) Schistosomal glomerulopathies. Kidney Int 44:1–12

    Article  PubMed  CAS  Google Scholar 

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Acknowledgements

The authors are thankful to Dr. Francesco Emma for critical review of the manuscript.

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Correspondence to Arpana Iyengar.

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Answers: 1. a; 2. b; 3. b; 4. a; 5. b

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Kamath, N., Iyengar, A. Infections and the kidney: a tale from the tropics. Pediatr Nephrol 33, 1317–1326 (2018). https://doi.org/10.1007/s00467-017-3785-2

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