Renal lesions in leprosy: A retrospective study of 199 autopsies

In the present work, 199 patients with leprosy who underwent autopsy betwee n 1970 and 1986 were retrospectively studied to determine the prevalence, t ypes, clinical characteristics, and etiologic factors of renal lesions (RLs ) in leprosy. Patients were divided into two groups: 144 patients with RLs (RL+) and 55 patients without RLs (RL-), RLs observed in 72% of the autopsi ed patients were amyloidosis (AMY) in 61 patients (31%), glomerulonephritis (GN) in 29 patients (14%), nephrosclerosis (NPS) in 22 patients (11%), tub ulointerstitial nephritis (TIN) in 18 patients (9%), granuloma in 2 patient s (1%), and other lesions in 12 patients (6%), AMY occurred most frequently in patients with lepromatous leprosy (36%; nonlepromatous leprosy, 5%; P < 0.01), recurrent erythema nodosum leprosum (33%; P < 0.02), and trophic ul cers (27%; 0.05 < P < 0.10), Ninety-seven percent of AMY was found in patie nts with lepromatous leprosy, 88% showed recurrent trophic ulcers, and 76% presented with erythema nodosum leprosum, NPS was found in older patients w ith arterial hypertension, neoplastic diseases, infectious diseases, and va sculitis associated with GN, Most patients with AMY presented with proteinu ria (95%) and renal failure (88%), The most frequent causes of death were r enal failure in patients with AMY (57%), infectious diseases in patients wi th GN (41%) and TIN (45%), and cardiovascular diseases in patients with NPS (41%), No difference in survival rates was observed among RL- patients and those with AMY, GN, NPS, or TIN. (C) 2001 by the National Kidney Foundatio n, Inc.