Montazeri Mahbobeh, Fakhar Mahdi, Sedighi Omid, Makhlough Atieh, Tabaripour Rabeeh, Nakhaei Maryam, Soleymani Mostafa
Toxoplasmosis Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran.
Iranian National Registry Center for Lophomoniasis and Toxoplasmosis, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran.
BMC Nephrol. 2025 Mar 31;26(1):163. doi: 10.1186/s12882-025-04079-2.
Patients with chronic kidney disease (CKD) are susceptible to acquiring opportunistic parasites due to acquired immunodeficiency caused by uremia. Therefore, the present case-control study attempted to determine the prevalence of T. gondii infection and also associated risk factors among patients with CKD under hemodialysis and healthy controls who were registered at the Iranian National Registry Center for Toxoplasmosis (INRCT) in Mazandaran Province, northern Iran.
212 cases with CKD and 200 healthy controls were enrolled in this study. Informed consent as well as a questionnaire were obtained from all subjects. Blood samples were collected from each participant and the serum was screened for anti-Toxoplasma antibodies (IgG and IgM). PCR assay was performed to detect circulating T. gondii in the blood samples of patients and controls using the primer pair targeting the RE gene.
Out of 412 participants, 67.92% of patients and 15.5% of control subjects were positive for anti-Toxoplasma IgG, but all participants were negative for anti-Toxoplasma IgM. Also, considering PCR assays with RE target, the prevalence of T. gondii infection was 24.1% in case subjects, while none of the control subjects tested positive. Among the PCR positive, 34 (66.7%) had Toxoplasma IgG positivity. The results from the multiple multinomial logistic regression revealed that the seroprevalence of anti-T. gondii IgG antibodies in patients with CKD was 3.12 times higher than in healthy controls (OR = 3.12; 95% CI = 0.43, 14.8; P < 0.001). Also, there was a significant association between seroprevalence of T. gondii infection and age, having a cat at home, and level of glomerular filtration rate (GFR) in these patients.
Our findings demonstrate a highly significant association between latent T. gondii infection and CKD, mostly in the late stages. Thus, regular screening for T. gondii infection in these patients is strongly recommended to prevent the reactivation of latent infections. A combination of serological screening, chemoprophylaxis, and PCR follow-up for patients at risk of reactivation should effectively reduce the likelihood of latent infection reactivation.
Not applicable.
慢性肾脏病（CKD）患者由于尿毒症导致获得性免疫缺陷，易感染机会性寄生虫。因此，本病例对照研究试图确定伊朗北部马赞德兰省伊朗国家弓形虫病登记中心（INRCT）登记的接受血液透析的CKD患者和健康对照中弓形虫感染的患病率及其相关危险因素。
本研究纳入了212例CKD患者和200名健康对照。所有受试者均签署知情同意书并填写问卷。采集每位参与者的血样，检测血清中的抗弓形虫抗体（IgG和IgM）。使用靶向RE基因的引物对，对患者和对照的血样进行PCR检测，以检测循环中的弓形虫。
在412名参与者中，67.92%的患者和15.5%的对照抗弓形虫IgG呈阳性，但所有参与者抗弓形虫IgM均为阴性。此外，考虑以RE基因为靶点的PCR检测，病例组弓形虫感染患病率为24.1%，而对照组均未检测出阳性。在PCR阳性者中，34例（66.7%）弓形虫IgG呈阳性。多项多分类逻辑回归结果显示，CKD患者抗弓形虫IgG抗体的血清阳性率比健康对照高3.12倍（OR = 3.12；95%CI = 0.43，14.8；P < 0.001）。此外，这些患者中弓形虫感染的血清阳性率与年龄、家中养猫情况以及肾小球滤过率（GFR）水平之间存在显著关联。
我们的研究结果表明，潜伏性弓形虫感染与CKD之间存在高度显著的关联，主要在晚期。因此，强烈建议对这些患者定期进行弓形虫感染筛查，以预防潜伏感染的激活。对有激活风险的患者进行血清学筛查、化学预防和PCR随访相结合，应能有效降低潜伏感染激活的可能性。
不适用。
