Renal function improvement with pentavalent antimonial agents in patients with visceral leishmaniasis.

BACKGROUND

The aim of this study is to investigate tubular and glomerular function after visceral leishmaniasis (VL) treatment with pentavalent antimonials.

METHODS

This is a prospective study including 14 patients with VL diagnosis treated with pentavalent antimonials. Urine acidification and concentration tests were performed. Estimated glomerular filtration rate (eGFR), fractional excretion of sodium (FE(Na)) and potassium (FE(K)) and free water clearance (C(H2O)) were measured to assess glomerular and tubular function.

RESULTS

The VL group had a significantly lower FE(K), serum sodium and plasma osmolality (P(osm)). No significant differences were found regarding proteinuria, eGFR, FE(Na) or C(H2O). Patients in the VL group had lower urinary osmolality (U(osm)) before DDAVP use when compared to the control group, as well as a lower U/P(osm). The urinary pH before and after CaCl(2) load was higher in the VL group.

CONCLUSIONS

This study shows evidence of reversal of some tubular dysfunction in VL, but other dysfunctions may persist, especially urinary acidification capacity.