Analysis of renal function in onchocerciasis patients before and after therapy.
The occurrence of renal abnormalities was investigated in patients with onchocerciasis in comparison to individuals without onchocerciasis in Guinea. Serum creatinine levels, excretion of urinary marker proteins, and kidney size by ultrasound were determined. A high prevalence of glomerular as well as tubular dysfunctions was observed; however, no association with onchocerciasis could be detected. We also hypothesized that patients with hyperreactive onchocerciasis might be prone to develop immune-mediated glomerular disorders; however, this could not be verified. Following treatment with ivermectin, a slight but significant increase in the excretion of urinary albumin and alpha1-microglobulin was seen five days after treatment in all treated patients, whereas levels of proteinuria were significantly higher five days after treatment only in patients with high microfilarial densities. Our results indicate that ivermectin can cause glomerular and tubular disturbances in patients with onchocerciasis; however, these are minor and do not seem to be clinically relevant.
Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany.
G D
GD
Burchard
T
T
Kubica
F W
FW
Tischendorf
T
T
Kruppa
N W
NW
Brattig
D000328:Adult; D000419:Albuminuria / Q000503:physiopathology; D000818:Animals; D000871:Anthelmintics / Q000009:adverse effects / Q000627:therapeutic use*; D001774:Blood Chemical Analysis; D001786:Blood Glucose / Q000032:analysis; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006023:Glycoproteins / Q000097:blood / Q000652:urine; D016701:Guinea; D006801:Humans; D007559:Ivermectin / Q000009:adverse effects / Q000627:therapeutic use*; D007668:Kidney / Q000000981:diagnostic imaging / Q000503:physiopathology*; D007677:Kidney Function Tests; D008297:Male; D008562:Membrane Glycoproteins; D008875:Middle Aged; D017181:Onchocerca volvulus / Q000187:drug effects*; D009855:Onchocerciasis / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D012016:Reference Values; D012709:Serum Albumin / Q000032:analysis; D014360:Trypsin Inhibitor, Kunitz Soybean; D014463:Ultrasonography
D000871:Anthelmintics; D001786:Blood Glucose; D006023:Glycoproteins; D008562:Membrane Glycoproteins; C109148:SPINT2 protein, human; D012709:Serum Albumin; D007559:Ivermectin; D014360:Trypsin Inhibitor, Kunitz Soybean