Analysis of renal function in onchocerciasis patients before and after therapy

The occurrence of renal abnormalities was investigated in patients with onc hocerciasis in comparison to individuals without onchocerciasis in Guinea. Serum creatinine levels, excretion of urinary marker proteins, and kidney s ize by ultrasound were determined. A high prevalence of glomerular as well as tubular dysfunctions was observed; however, no association with onchocer ciasis could be detected. We also hypothesized that patients with hyperreac tive onchocerciasis might be prone to develop immune-mediated glomerular di sorders; however this could not be verified. Following treatment with iverm ectin, a slight but significant increase in the excretion of urinary albumi n and al-microglobulin was seen five days after treatment in all treated pa tients, whereas levels of proteinuria were significantly higher five days a fter treatment only in patients with high microfilarial densities. Our resu lts indicate that ivermectin can cause glomerular and tubular disturbances in patients with onchocerciasis; however, these are minor and do not seem t o be clinically relevant.