Preliminary Study for New Markers of Early Tubuloglomerular Injury and Renal Inflammation in Patients with Visceral Leishmaniasis Receiving Liposomal Amphotericin B Treatment

Visceral leishmaniasis is treated with liposomal amphotericin B (L-AMB), which is associated with nephrotoxicity. Thus, we aimed to investigate nephrotoxicity through novel renal biomarkers in patients with visceral leishmaniasis during L-AMB use. Ours was a prospective study with 17 patients with v...

Full description

Saved in:
Bibliographic Details
Published in:The American journal of tropical medicine and hygiene 2022-04, Vol.106 (4), p.1191-1195
Main Authors: Bezerra, Gabriela Freire, Meneses, Gdayllon Cavalcante, Jacinto, Vittória Nobre, Lima, Danya Bandeira, Magalhães, Emanuel Paula, Lima, Lana Andrade Lucena, Rocha, Thaiany Pereira da, de Azevedo, Isabella Evelyn Prado, da Silva, Jr, Geraldo Bezerra, Daher, Elizabeth De Francesco, Martins, Alice Maria Costa
Format: Article
Language:English
Subjects:
Antifungal agents
Biomarkers
Kidneys
Parasitic diseases
Short Report
Citations: Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Visceral leishmaniasis is treated with liposomal amphotericin B (L-AMB), which is associated with nephrotoxicity. Thus, we aimed to investigate nephrotoxicity through novel renal biomarkers in patients with visceral leishmaniasis during L-AMB use. Ours was a prospective study with 17 patients with visceral leishmaniasis treated with L-AMB during their hospital stay. Laboratory tests, renal parameters, urinary biomarkers (urinary kidney injury molecule 1, urinary monocyte chemoattractant protein 1 [uMCP-1], sodium-potassium-2 chloride cotransporter [NKCC2], sodium-hydrogen exchanger 3) [NHE3], aquaporin 2 [AQP2], tumor susceptibility gene 101 [TSH 101], and serum inflammatory biomarkers (MCP-1, interferon-γ, and IL-6) were evaluated in two periods: before and during L-AMB use. Glomerular filtration rate, creatinine, proteinuria, and albuminuria were similar before and during L-AMB use. IL-6 levels, AQT2, and NHE3 expression decreased, whereas uMCP-1 and urinary kidney injury molecule 1 levels increased during L-AMB treatment. In patients who developed acute kidney injury, uMCP-1 showed higher levels. L-AMB aggravated tubuloglomerular lesions, inflammation, and renal tubular disorders. Thus, patients treated with L-AMB need to be monitored for inflammatory and electrolyte disturbances to prevent acute kidney injury, longer length of hospital stay, higher public costs, and mortality.
ISSN:0002-9637
1476-1645
DOI:10.4269/ajtmh.21-0978