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Bezerra GF, Meneses GC, Jacinto VN, Lima DB, Magalhães EP, Lima LAL, da Rocha TP, de Azevedo IEP, da Silva Jr. GB, Daher EDF, Martins AMC. Preliminary Study for New Markers of Early Tubuloglomerular Injury and Renal Inflammation in Patients with Visceral Leishmaniasis Receiving Liposomal Amphotericin B Treatment. Am J Trop Med Hyg 2022; 106:1191-1195. [PMID: 35189590 PMCID: PMC8991337 DOI: 10.4269/ajtmh.21-0978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 12/18/2021] [Indexed: 11/07/2022] Open
Abstract
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.
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Affiliation(s)
- Gabriela Freire Bezerra
- Pharmacology Postgraduate Program, Department of Physiology and Pharmacology, School of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Gdayllon Cavalcante Meneses
- Medical Sciences Postgraduate Program, Department of Internal Medicine, School of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Vittória Nobre Jacinto
- Medical Sciences Postgraduate Program, Department of Internal Medicine, School of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Danya Bandeira Lima
- Clinical and Toxicological Analysis Department, School of Pharmacy, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Emanuel Paula Magalhães
- Clinical and Toxicological Analysis Department, School of Pharmacy, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Lana Andrade Lucena Lima
- Clinical and Toxicological Analysis Department, School of Pharmacy, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Thaiany Pereira da Rocha
- Clinical and Toxicological Analysis Department, School of Pharmacy, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | | | - Geraldo Bezerra da Silva Jr.
- Collective Health Graduate Program, School of Medicine, Health Sciences Center, University of Fortaleza, Fortaleza, Ceará, Brazil
| | - Elizabeth De Francesco Daher
- Medical Sciences Postgraduate Program, Department of Internal Medicine, School of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Alice Maria Costa Martins
- Pharmacology Postgraduate Program, Department of Physiology and Pharmacology, School of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil
- Clinical and Toxicological Analysis Department, School of Pharmacy, Federal University of Ceará, Fortaleza, Ceará, Brazil
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Bezerra GF, Daher EDF, Meneses GC, Bezerra da Silva Junior G, Donadello TL, Rocha TP, Azevedo IEP, Pequeno MGC, Lima DB, Jacinto VN, Martins AMC. SP127ASSOCIATION OF URINARY MCP-1 WITH THE NEPHROTOXICITY OF LIPOSOMAL ANFOTERICIN B IN PATIENTS WITH VISCERAL LEISHMANIOSIS. Nephrol Dial Transplant 2019. [DOI: 10.1093/ndt/gfz103.sp127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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