title: Renal involvement in leishmaniasis: a review of the literature.
abstract: Leishmaniasis, an infectious disease endemic in tropical, Asian and southern European countries, is caused by obligate intramacrophage protozoa and is transmitted through the bite of infected female sandflies. More than 20 leishmanial species are responsible for four main clinical syndromes: cutaneous leishmaniasis; mucocutaneous leishmaniasis; visceral leishmaniasis, also known as kala-azar, and post-kala-azar dermal leishmaniasis. Visceral leishmaniasis can present with varying clinical features and the kidney can also be involved. Both glomerular and tubular function can be altered and patients can develop proteinuria, haematuria, abnormalities in urinary concentration and acidification and acute and chronic renal insufficiency. Not only the disease itself but also the therapy administered might be responsible for the renal involvement in kala-azar. Indeed, some of the agents with efficiency against visceral leishmaniasis, such as pentavalent antimonial drugs, amphotericin B, pentamidine, miltefosine, paromomycin and simataquine, may be associated with a high risk of renal toxicity. In this article, the literature on renal involvement in visceral leishmaniasis is reviewed.
authors.affiliation: Department of Nephrology Dialysis & Transplantation, San Bortolo Hospital, Vicenza, Italy ; International Renal Research Institute (IRRIV), Vicenza, Italy ; Department of Internal Medicine, Policlinico Universitario, Catania, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Clementi
authors.affiliation: Department of Nephrology, Santa Marta e Santa Venera, Catania, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Battaglia
authors.affiliation: Department of Nephrology Dialysis & Transplantation, San Bortolo Hospital, Vicenza, Italy ; International Renal Research Institute (IRRIV), Vicenza, Italy ; Department of Nephrology San Michele Hospital, Cagliari, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Floris
authors.affiliation: Department of Internal Medicine, Policlinico Universitario, Catania, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Castellino
authors.affiliation: Department of Nephrology Dialysis & Transplantation, San Bortolo Hospital, Vicenza, Italy ; International Renal Research Institute (IRRIV), Vicenza, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Ronco
authors.affiliation: Department of Nephrology Dialysis & Transplantation, San Bortolo Hospital, Vicenza, Italy ; International Renal Research Institute (IRRIV), Vicenza, Italy.
authors.forename: Dinna N
authors.initials: DN
authors.lastname: Cruz
keywords: nephrotoxicity; renal involvement; visceral leishmaniasis