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


CONCLUSIONS
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.
Department of Internal Medicine, School of Medicine, Federal University of Ceará, Campus Cariri, Rua Divino Salvador, Centro, Barbalha, Ceará, Brazil. rodrigoalves@ufc.br
Rodrigo A
RA
Oliveira
Cláudio G
CG
Lima
Rosa Ms
RM
Mota
Alice Mc
AM
Martins
Talita R
TR
Sanches
Antônio C
AC
Seguro
Lúcia C
LC
Andrade
Geraldo B Silva
GB
Junior
Alexandre B
AB
Libório
Elizabeth F
EF
Daher
D000328:Adult; D000981:Antiprotozoal Agents / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007668:Kidney / Q000187:drug effects / Q000502:physiology*; D007674:Kidney Diseases / Q000175:diagnosis / Q000503:physiopathology / Q000652:urine; D016773:Leishmaniasis, Cutaneous / Q000188:drug therapy* / Q000503:physiopathology / Q000652:urine; D008297:Male; D008536:Meglumine / Q000494:pharmacology / Q000627:therapeutic use*; D000077485:Meglumine Antimoniate; D008875:Middle Aged; D009942:Organometallic Compounds / Q000494:pharmacology / Q000627:therapeutic use*; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult
D000981:Antiprotozoal Agents; D009942:Organometallic Compounds; D008536:Meglumine; D000077485:Meglumine Antimoniate