TY - JOUR
KW - Adult
KW - Brazil
KW - Cross-Sectional Studies
KW - Female
KW - Glomerular Filtration Rate
KW - Humans
KW - Kidney Function Tests
KW - Kidney Tubules
KW - leprosy
KW - Male
AU - Oliveira R
AU - Silva G
AU - Souza CJ
AU - Vieira E
AU - Mota R
AU - Martins AMC
AU - Libório AB
AU - Daher E
AB - <p><b>BACKGROUND: </b>Renal abnormalities in leprosy have been largely described in medical literature, but there are few studies evaluating renal function in these patients.</p><p><b>METHODS: </b>This is a cross-sectional study in 59 consecutive paucibacillary (PB) and multibacillary (MB) leprosy patients. Glomerular filtration rate (GFR) was estimated by simplified-MDRD formula. Microalbuminuria was determined by 24 h urine collection. Urinary acidification capacity was measured after water deprivation and acid-loading with CaCl(2). Urinary concentration capacity was evaluated after desmopressin acetate administration, using the urinary to plasma osmolality (U/P(osm)) ratio. All parameters except microalbuminuria were measured in a control group of 18 healthy volunteers.</p><p><b>RESULTS: </b>Age and gender were similar between leprosy (MB or PB) and control groups. GFR <or= 80 ml/min/1.73 m(2) was observed in 50% of the leprosy patients. GFR and U/P(osm) in leprosy patients were significantly lower than in controls (P<0.001). Urinary acidification defect was found in 32% of PB and in 29% of MB patients and urinary concentrating ability was abnormal in 83% of PB and 85% of MB patients. Microalbuminuria was found in 4 patients (8.5%), leukocyturia was found in 13 (22%) and haematuria was present in 16 patients (27%). Plasma creatinine (P(cr)) >1.2 mg/dl was observed in 17.9% of MB patients and in none of the controls (P=0.020). A negative correlation was observed between GFR and time of treatment (r= -0.339; P=0.002). Age and time of treatment were independent risk factors for GFR <or= 80 ml/min/1.73 m(2) in multivariate analysis.</p><p><b>CONCLUSIONS: </b>Asymptomatic GFR changes and renal tubular dysfunction, including urine concentration defect and impaired acidifying mechanisms, can be caused by leprosy on specific treatment and without any reaction episodes.</p>
BT - Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
C1 - http://www.ncbi.nlm.nih.gov/pubmed/17901068?dopt=Abstract
DA - 2008 Jan
DO - 10.1093/ndt/gfm568
IS - 1
J2 - Nephrol. Dial. Transplant.
LA - eng
N2 - <p><b>BACKGROUND: </b>Renal abnormalities in leprosy have been largely described in medical literature, but there are few studies evaluating renal function in these patients.</p><p><b>METHODS: </b>This is a cross-sectional study in 59 consecutive paucibacillary (PB) and multibacillary (MB) leprosy patients. Glomerular filtration rate (GFR) was estimated by simplified-MDRD formula. Microalbuminuria was determined by 24 h urine collection. Urinary acidification capacity was measured after water deprivation and acid-loading with CaCl(2). Urinary concentration capacity was evaluated after desmopressin acetate administration, using the urinary to plasma osmolality (U/P(osm)) ratio. All parameters except microalbuminuria were measured in a control group of 18 healthy volunteers.</p><p><b>RESULTS: </b>Age and gender were similar between leprosy (MB or PB) and control groups. GFR <or= 80 ml/min/1.73 m(2) was observed in 50% of the leprosy patients. GFR and U/P(osm) in leprosy patients were significantly lower than in controls (P<0.001). Urinary acidification defect was found in 32% of PB and in 29% of MB patients and urinary concentrating ability was abnormal in 83% of PB and 85% of MB patients. Microalbuminuria was found in 4 patients (8.5%), leukocyturia was found in 13 (22%) and haematuria was present in 16 patients (27%). Plasma creatinine (P(cr)) >1.2 mg/dl was observed in 17.9% of MB patients and in none of the controls (P=0.020). A negative correlation was observed between GFR and time of treatment (r= -0.339; P=0.002). Age and time of treatment were independent risk factors for GFR <or= 80 ml/min/1.73 m(2) in multivariate analysis.</p><p><b>CONCLUSIONS: </b>Asymptomatic GFR changes and renal tubular dysfunction, including urine concentration defect and impaired acidifying mechanisms, can be caused by leprosy on specific treatment and without any reaction episodes.</p>
PY - 2008
SP - 256
EP - 62
T2 - Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
TI - Evaluation of renal function in leprosy: a study of 59 consecutive patients.
VL - 23
SN - 0931-0509
ER -