title: Cystatin C as a marker of immune complex-associated renal impairment in a Sudanese population with visceral leishmaniasis.
abstract: Renal function was studied in visceral leishmaniasis (VL) and post-kala-azar dermal leishmaniasis (PKDL) by means of the specific marker cystatin C and related to circulating immune complexes and cytokine production. Forty patients with VL (23 with sub-acute disease and 17 with acute disease), 17 patients with PKDL, and 22 healthy controls were included. Cystatin C, but not creatinine, was significantly raised in VL (P = 0.004). The highest levels of cystatin C were found in those with acute disease (P < 0.0001). In VL, cystatin C levels were positively correlated to circulating immune complexes and production of granulocyte-macrophage colony stimulating factor (GM-CSF), but negatively correlated to aspartate aminotransferase and lactate dehydrogenase. We conclude that cystatin C is a superior marker of glomerular function in leishmaniasis and that immune complex deposition and GM-CSF are two functions that most likely are causally involved in the mechanisms leading to glomerular dysfunction in leishmaniasis.
authors.affiliation: Department of Clinical Pathology and Microbiology, Alribat University Hospital, Khartoum, Sudan. amirel1970@hotmail.com
authors.forename: Amir Ibrahim
authors.initials: AI
authors.lastname: ElShafie
authors.forename: Gehad
authors.initials: G
authors.lastname: Elghazali
authors.forename: Johan
authors.initials: J
authors.lastname: Rönnelid
authors.forename: Per
authors.initials: P
authors.lastname: Venge
mesh_terms: D000913:Antibodies, Protozoan / Q000097:blood; D000953:Antigens, Protozoan / Q000276:immunology*; D015415:Biomarkers / Q000097:blood; D055316:Cystatin C; D015891:Cystatins / Q000032:analysis*; D007898:Leishmaniasis, Visceral / Q000175:diagnosis* / Q000276:immunology; D010274:Parasitology / Q000379:methods; D051437:Renal Insufficiency; D013397:Sudan / Q000453:epidemiology
chemical_list: D000913:Antibodies, Protozoan; D000953:Antigens, Protozoan; D015415:Biomarkers; D055316:Cystatin C; D015891:Cystatins