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被忽视的热带病与肾脏

Neglected Tropical Diseases and the Kidneys.

机构信息

Public Health and Medical Sciences Graduate Programs, School of Medicine, University of Fortaleza, Fortaleza, Brazil.

Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.

出版信息

Contrib Nephrol. 2021;199:201-228. doi: 10.1159/000517724. Epub 2021 Aug 3.

Abstract

Clinical Background: Neglected tropical diseases (NTDs), a major public health problem, frequently affect the kidneys. In this chapter, we discuss the NTDs which have been most studied in terms of renal involvement and present a summary of current knowledge regarding kidney disease in all NTDs, through a literature review. Epidemiology: There are more than 1 billion people in the world affected by NTDs. These infections can also be one of the etiologies of chronic kidney disease of unknown cause, which is another great public health problem in Latin America, and these diseases are most prevalent in young people, males, in their productive years, which increases its burden on the society. Challenges: Early detection of renal involvement is crucial to decrease the magnitude of the manifestations and hence allow more favorable outcomes, and for this purpose novel kidney injury biomarkers are a promising solution. Unfortunately, specific treatments for NTDs have not changed in the last decades, as novel drugs have not been investigated. Prevention and Treatment: Prevention includes vector control, blood bank tests, periodic serologic surveys, and health surveillance in general in order to decrease oral transmission and to maintain good hygiene conditions. Recently, many potential therapeutic targets have been evidenced in both clinical and experimental studies.

摘要

临床背景

被忽视的热带病(NTDs)是一个主要的公共卫生问题,常累及肾脏。在这一章中,我们通过文献复习,讨论了在肾脏受累方面研究最多的 NTDs,并就所有 NTDs 中的肾脏疾病的现有知识进行了总结。

流行病学

全球有超过 10 亿人受到 NTDs 的影响。这些感染也可能是不明原因的慢性肾脏病的病因之一,在拉丁美洲,这也是另一个重大的公共卫生问题,这些疾病在年轻人、男性、生育年龄的人群中更为普遍,这增加了它们对社会的负担。

挑战

早期发现肾脏受累对于减少临床表现的严重程度从而获得更好的结果至关重要,为此,新型肾脏损伤生物标志物是一种很有前途的解决方案。不幸的是,过去几十年中,NTDs 的具体治疗方法并没有改变,因为尚未研究新型药物。

预防和治疗

预防包括控制病媒、血库检测、定期血清学调查以及一般的健康监测,以减少经口传播,并保持良好的卫生条件。最近,在临床和实验研究中都证实了许多潜在的治疗靶点。

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