School of Medicine, Federal University of Ceara, Fortaleza, Ceara, Brazil.
School of Medicine, University of Fortaleza, Fortaleza, Ceara, Brazil.
Nat Rev Nephrol. 2022 Jun;18(6):396-406. doi: 10.1038/s41581-022-00558-z. Epub 2022 Mar 28.
Parasitic agents have been known to cause human disease since ancient times and are endemic in tropical and subtropical regions. Complications of parasitic diseases, including kidney involvement, are associated with worse outcomes. Chagas disease, filariasis, leishmaniasis, malaria and schistosomiasis are important parasitic diseases that can damage the kidney. These diseases affect millions of people worldwide, primarily in Africa, Asia and Latin America, and kidney involvement is associated with increased mortality. The most common kidney complications of parasitic diseases are acute kidney injury, glomerulonephritis and tubular dysfunction. The mechanisms that underlie parasitic disease-associated kidney injury include direct parasite damage; immunological phenomena, including immune complex deposition and inflammation; and systemic manifestations such as haemolysis, haemorrhage and rhabdomyolysis. In addition, use of nephrotoxic drugs to treat parasitic infections is associated with acute kidney injury. Early diagnosis of kidney involvement and adequate management is crucial to prevent progression of kidney disease and optimize patient recovery.
寄生虫病原体自古就可导致人类疾病,并在热带和亚热带地区流行。寄生虫病的并发症,包括肾脏受累,与较差的预后相关。恰加斯病、血丝虫病、利什曼病、疟疾和血吸虫病是重要的寄生虫病,可损害肾脏。这些疾病影响着全世界数百万人,主要在非洲、亚洲和拉丁美洲,肾脏受累与死亡率增加相关。寄生虫病最常见的肾脏并发症是急性肾损伤、肾小球肾炎和肾小管功能障碍。寄生虫病相关肾损伤的发病机制包括直接寄生虫损伤;免疫现象,包括免疫复合物沉积和炎症;以及全身性表现,如溶血性贫血、出血和横纹肌溶解。此外,用肾毒性药物治疗寄生虫感染与急性肾损伤相关。早期诊断肾脏受累并进行充分治疗对于预防肾脏病进展和优化患者康复至关重要。