Kidney complications of parasitic diseases.
Elizabeth de Francesco DaherGeraldo Bezerra da Silva JuniorMayuri TrivediTarek FayadNattachai SrisawatSanjeev NairPadet SiriyasatienMarcus Vinícius Guimarães de LacerdaMaria Alice Sperto Ferreira BaptistaMahesha VankalakuntiVivekananda JhaPublished in: Nature reviews. Nephrology (2022)
Parasitic agents have been known to cause human disease since ancient times and are endemic in tropical and subtropical regions. Complications of parasitic diseases, including kidney involvement, are associated with worse outcomes. Chagas disease, filariasis, leishmaniasis, malaria and schistosomiasis are important parasitic diseases that can damage the kidney. These diseases affect millions of people worldwide, primarily in Africa, Asia and Latin America, and kidney involvement is associated with increased mortality. The most common kidney complications of parasitic diseases are acute kidney injury, glomerulonephritis and tubular dysfunction. The mechanisms that underlie parasitic disease-associated kidney injury include direct parasite damage; immunological phenomena, including immune complex deposition and inflammation; and systemic manifestations such as haemolysis, haemorrhage and rhabdomyolysis. In addition, use of nephrotoxic drugs to treat parasitic infections is associated with acute kidney injury. Early diagnosis of kidney involvement and adequate management is crucial to prevent progression of kidney disease and optimize patient recovery.