02965nas a2200301   4500000000100000008004100001260005300042653002200095653003000117653002700147653002200174653001600196653001200212100001800224700001700242700001700259700001600276700001700292700002900309700001700338700002000355245010400375856007300479300001100552490000700563520207900570022001402649       2026                            d  c06/2026bSpringer Science and Business Media LLC10aRenal involvement10aErythema Nodosum Leprosum10aMultibacillary leprosy10aMultidrug therapy10aProteinuria10aleprosy1 ade Oliveira K1 aCorrêa LMDA1 aBrandão LKV1 aPinheiro IM1 aYoshimoto NH1 ado Nascimento Meneses MC1 aCazzaniga RA1 ade Oliveira CJF00aRenal Involvement in Leprosy in the Multidrug Therapy Era: Current Evidence and Clinical Monitoring  uhttps://link.springer.com/content/pdf/10.1007/s40475-026-00372-8.pdf  a1 - 130 v133 a<p><strong>Purpose of Review</strong></p>

<p>Leprosy remains a contemporary tropical-medicine challenge in which systemic complications may be overlooked when follow-up is centered on skin lesions, peripheral nerves, and completion of multidrug therapy (MDT). This review synthesizes historical and MDT-era evidence on renal involvement in leprosy and reframes kidney assessment as a practical complication-monitoring issue for infectious-disease care.</p>

<p><strong>Recent Findings</strong></p>

<p>Classical clinicopathologic studies established that leprosy may be associated with glomerular disease, tubulointerstitial injury, and amyloid A amyloidosis, particularly in multibacillary or lepromatous disease with recurrent erythema nodosum leprosum (ENL). In the MDT era, severe nephropathy appears less dominant, whereas renal involvement may be expressed through milder, dynamic, and context-dependent abnormalities, including albuminuria or proteinuria, microscopic hematuria, mild creatinine elevation, estimated glomerular filtration rate decline, and investigational inflammatory or endothelial signals such as MCP-1 and VCAM-1. These findings should be interpreted probabilistically, because bacillary burden, reactional inflammation, delayed diagnosis, hypertension, nephrotoxic exposure, dehydration, sepsis, and rifampicin-associated acute kidney injury may coexist.</p>

<p><strong>Summary</strong></p>

<p>Renal monitoring in leprosy should prioritize risk-enriched patients, including those with multibacillary disease, ENL or recurrent reactions, delayed diagnosis, abnormal urinalysis, hypertension, nephrotoxic exposure, or rising creatinine. Conventional assessment with serum creatinine, estimated glomerular filtration rate, urinalysis with microscopy, and albuminuria or proteinuria testing may help identify patients who require repeat evaluation, broader differential work-up, or nephrology referral. The proposed approach is a pragmatic synthesis for risk-based clinical reasoning, not a validated guideline or prognostic score.</p>
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