Renal involvement in chagas’ disease (American trypanosomiasis)

Abstract

Chagas disease is caused by the protozoa Trypanosoma cruzi, in which kidney injury is rarely described. The aim of this study is to describe the features of kidney injury in Chagas disease. This is a review study regarding kidney injury associated with Chagas disease. A deep search was performed in the main medical databases (PubMed and Scielo), using the keywords “Chagas disease” and “Kidney.” Renal involvement is a rare manifestation of Chagas’ disease, and there are few studies on the subject in literature. There is evidence of functional and structural renal alterations after T. cruzi infection. The occurrence of glomerulonephritis in the chronic phase of the disease has been reported in infections by T. cruzi. The pathophysiology of renal involvement in Chagas disease seems to include autoimmune phenomena. T. cruzi antigens have also been identified in renal graft glomeruli and interstitium in a patient with acute form of the Chagas disease. The most common lesions associated with the trypanosomes are mesangial proliferative glomerulonephritis and membranoproliferative glomerulonephritis. The specific treatment aims to cure the infection, prevent organ lesions or their progress, and decrease the possibility of T. cruzi transmission, being effective in most cases. Renal function deterioration is observed in patients with Chagas disease, but there is no currently consistent data demonstrating renal function recovery after specific treatment. Further studies are required to better investigate renal involvement in Chagas disease.