title: Urinary monocyte chemotactic protein-1 (MCP-1) in leprosy patients: increased risk for kidney damage.
abstract: BACKGROUND
  We aimed to evaluate urinary MCP-1 and oxidative stress through urinary malondialdehyde (MDA) in leprosy and correlate them with traditional, but less sensitive markers of renal disease.
  
  
  METHODS
  This is a cross-sectional study of 44 patients with diagnosis of leprosy and no previous treatment. Skin smear was assessed through a bacteriological index - from 0 to 6+. Glomerular filtration rate (GFR), protein excretion rate, microalbuminuria, urinary oxidative stress, malondialdehyde (MDA) and urinary MCP-1 were measured. Also, high- sensitivity C-reactive protein (hs-CRP) was measured in the blood. Fifteen healthy subjects composed a control group.
  
  
  RESULTS
  Age and gender were similar between leprosy patients and control groups. No patient had a GFR < 60 mL/min/1.73 m2 or albumin excretion rate greater than 30 mg/g-Cr. Leprosy patients had higher urinary protein excretion (97.6 ± 69.2 vs. 6.5 ± 4.3 mg/g-Cr, p < 0.001), urinary MCP-1 (101.0 ± 79.8 vs. 34.5 ± 14.9 mg/g-Cr, p = 0.006) and urinary MDA levels (1.77 ± 1.31 vs. 1.27 ± 0.66 mmol/g-Cr, p = 0.0372) than healthy controls. There was a positive correlation between urinary MCP-1 and bacteriological index in skin smears (r = 0.322, p = 0.035), urinary protein excretion (r = 0.547, p < 0.001), albumin excretion rate (r = 0.414, p = 0.006) and urinary MDA (r = 0.453, p = 0.002). After adjusting for hs-CRP, urinary MCP-1 remained correlated with albumin excretion rate (rpartial = 0.483, p = 0.007) and MDA levels (rpartial = 0.555, p = 0.001).
  
  
  CONCLUSIONS
  Leprosy patients with no clinical kidney disease have increased urinary MCP-1 mainly in lepromatous polar form. Inflammatory (MCP-1) and oxidative stress markers suggest leprosy patients are at high risk of developing kidney disease.
authors.forename: Gdayllon Cavalcante
authors.initials: GC
authors.lastname: Meneses
authors.affiliation: Department of Clinical Medicine, Faculty of Medicine, Federal University of Ceará, Fortaleza, Ceara, Brazil. alexandreliborio@yahoo.com.br.
authors.forename: Alexandre Braga
authors.initials: AB
authors.lastname: Libório
authors.forename: Elizabeth Francesco
authors.initials: EF
authors.lastname: de Daher
authors.forename: Geraldo Bezerra
authors.initials: GB
authors.lastname: da Silva
authors.forename: Marcus Felipe Bezerra
authors.initials: MF
authors.lastname: da Costa
authors.forename: Maria Araci Andrade
authors.initials: MA
authors.lastname: Pontes
authors.forename: Alice Maria Costa
authors.initials: AM
authors.lastname: Martins
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000378:metabolism; D002097:C-Reactive Protein; D018932:Chemokine CCL2 / Q000652:urine*; D003430:Cross-Sectional Studies; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000378:metabolism / Q000473:pathology; D007674:Kidney Diseases / Q000150:complications / Q000175:diagnosis; D007677:Kidney Function Tests; D007918:Leprosy / Q000150:complications / Q000652:urine*; D008297:Male; D008315:Malondialdehyde / Q000737:chemistry; D008875:Middle Aged; D018384:Oxidative Stress
chemical_list: D015415:Biomarkers; C111835:CCL2 protein, human; D018932:Chemokine CCL2; D008315:Malondialdehyde; D002097:C-Reactive Protein