Evaluation of Renal Function Profile in Human Visceral Leishmaniasis (Kala-Azar) Patients: A Case of Western Tigray, Ethiopia

Abstract

Background

Leishmaniasis is a vector-borne protozoan infection that has a wide clinical spectrum in the tropics and subtropics. Kidney damage is frequently associated with increased morbidity and mortality in visceral leishmaniasis (VL) patients. However, up to date, there is a very limited report on the effect of visceral leishmaniasis on kidney function profiling in Ethiopia.

Objective

To evaluate the renal function profile in human visceral leishmaniasis (kala-azar) patients.

Materials and Methods

Human blood was taken from VL patients (n = 100) and healthy controls (n = 100) attending Kahsay Abera and Mearg Hospitals, Western Tigray of Ethiopia. Serum was separated according to the conventional protocol and kidney function profiling (creatinine, urea, and uric acid) was analyzed by Mindray 200E automated chemistry analyzer. The estimated glomerular filtration rate (eGFR) was also assessed in this study. The obtained data were processed using SPSS Version 23.0. Descriptive statistics, independent-test, and bivariate correlations were used for data analysis. P values <0.05 were considered statistically significant at a 95% confidence level.

Results

The mean serum creatinine level was found significantly higher, while respective serum urea and eGFR were significantly lower in VL patients compared to healthy controls. Specifically, from 100 VL cases, an increased level of serum creatinine, urea, and uric acid was found in 10%, 9% and 15% VL cases, respectively; meanwhile, a decreased serum urea and eGFR have been reported from 33% to 44% VL cases, respectively.

Conclusion

The finding of this study asserted that visceral leishmaniasis causes derangement in kidney activities characterized by alteration of renal function profile. This may indicate that VL is the determinant factor for developing kidney dysfunction. This study encourages researchers to engage in visceral leishmaniasis and its effect on other organ function profiles in humans and identify potential markers for both prevention and intervention.

Keywords:

• visceral leishmaniasis
• renal function test
• creatinine
• urea
• glomerular filtration rate

Data Sharing Statement

All data pertaining to this study are contained and presented in this document and in the Supplementary Files. Anyone interested in the full data in Excel format can have the data by writing to [email protected].

Ethics Approval, Consent to Participate and Publication

Before starting data collection, an ethical clearance letter with reference number SOM/BCHM/121/011 was obtained from the Departmental Research and Ethics Review Committee, Department of Biochemistry, School of Medicine, College of Health Sciences, Addis Ababa University. A collaboration letter for data collection was also obtained from the Tigray Regional Health Bureau and the Administrators of Kahsay Abera and Mearg hospitals. Samples and data were collected after written informed consent had been obtained from study participants. For child participants (below the age of 18), written formal consent was obtained from the parents who accompanied them and the confidentiality of any information obtained from each participant was coded for the samples and results. Further permission was also obtained from Adigrat General Hospital to perform the clinical chemistry tests. Also, written informed consent for data collection and publication was already obtained (Supporting Information). The study was performed by the ethical standards of the Declaration of Helsinki and approved by the Ethics Committee of Addis Ababa University (Informed consent was obtained from all patients).

Acknowledgments

We are extremely grateful to the study participants for their valuable time and their willingness to participate in this study and to Addis Ababa University (AAU) for partial funding for this research project. The authors would like to acknowledge the staff members of Adigrat Referral Hospital. This paper is based on the thesis “Evaluation of renal function profile in human visceral leishmaniasis (kala-azar) patients by Kibrom Gerezgiher Asfaw.⁴⁸ It has been published on the Addis Ababa University website: http://etd.aau.edu.et/handle/123456789/23992.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors have declared that no competing interests exist.

Additional information

Funding

This research project is partly funded by Addis Ababa University. The funding organization has no role in data collection, data analysis, data interpretation and manuscript writing.