{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T10:44:23Z","timestamp":1789469063415,"version":"build-2803163510"},"reference-count":40,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Tropical Med Int Health"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Hansen disease is a neglected infectious disease associated with reactional inflammation, neuropathy and long\u2010term disability. Renal involvement and sarcopenia have been described separately, but their clinical coexistence has received limited attention. This review examines evidence for a hypothesised renal\u2013functional vulnerability interface and proposes a pragmatic monitoring framework for endemic settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a critical narrative review using structured, targeted searches of\n                      <jats:styled-content style=\"fixed-case\">PubMed<\/jats:styled-content>\n                      \/\n                      <jats:styled-content style=\"fixed-case\">MEDLINE<\/jats:styled-content>\n                      , Embase, Scopus and Web of Science from database inception to 1 June 2026, supplemented by manual reference screening. Eligible sources addressed Hansen disease, renal involvement, urinary abnormalities, sarcopenia, body composition, muscle strength, disability, neuropathy, reactional states, nutrition and treatment exposure. No formal risk\u2010of\u2010bias tool was applied; greater interpretive weight was given to primary clinical data, systematic reviews, consensus statements and guidelines.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Evidence indicates heterogeneous renal manifestations in Hansen disease, including proteinuria, haematuria, albuminuria, urinary biomarker abnormalities, glomerulonephritis, tubulointerstitial disease and amyloidosis. Separately, older survivor cohorts show increased adiposity, reduced appendicular skeletal muscle mass and higher sarcopenia prevalence. Sarcopenia should be interpreted primarily through neuropathy, pain, deformity, ulcers, immobility, ageing, corticosteroid exposure and social or nutritional vulnerability; renal involvement is, at most, a plausible cofactor. Low muscle mass may also lead to under\u2010recognition of renal impairment when creatinine\u2010based eGFR is used.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Current evidence does not prove a causal renal\u2013muscle relationship, but supports a hypothesised renal\u2013functional vulnerability interface. Integrated renal and functional assessment may help identify high\u2010risk patients and guide prospective cohorts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/tmi.70231","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T09:30:23Z","timestamp":1789464623000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Renal and Functional Vulnerability in Hansen Disease: A Framework for Chronic Infectious Disability in Endemic Settings"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2822-7958","authenticated-orcid":false,"given":"Kleberson","family":"de Oliveira","sequence":"first","affiliation":[{"name":"Universidade Federal Do Tri\u00e2ngulo Mineiro (UFTM)  Uberaba Minas Gerais Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-7247-4950","authenticated-orcid":false,"given":"Lucas Maciel de Almeida","family":"Corr\u00eaa","sequence":"additional","affiliation":[{"name":"Faculdade de Medicina de S\u00e3o Jos\u00e9 do Rio Preto (FAMERP)  S\u00e3o Jos\u00e9 do Rio Preto S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-6044-4265","authenticated-orcid":false,"given":"Isabela Malerba","family":"Pinheiro","sequence":"additional","affiliation":[{"name":"Pontif\u00edcia Universidade Cat\u00f3lica de Minas Gerais (PUC MINAS)  Po\u00e7os de Caldas Minas Gerais Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-3274-2319","authenticated-orcid":false,"given":"Alexandre de Assis","family":"Barbosa","sequence":"additional","affiliation":[{"name":"Universidade Estadual de Mato Grosso Do Sul (UEMS)  Campo Grande Mato Grosso do Sul Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-7273-7765","authenticated-orcid":false,"given":"Maria Eduarda Castro","family":"Gon\u00e7alves","sequence":"additional","affiliation":[{"name":"Pontif\u00edcia Universidade Cat\u00f3lica Do Paran\u00e1 (PUCPR)  Curitiba Paran\u00e1 Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7546-1620","authenticated-orcid":false,"given":"Lara Lucena Fernandes","family":"Filgueiras","sequence":"additional","affiliation":[{"name":"Faculdade de Medicina Nova Esperan\u00e7a (FAMENE)  Jo\u00e3o Pessoa Para\u00edba Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-6567-1220","authenticated-orcid":false,"given":"Lara Reis Gomes de Mello","family":"Queiroz","sequence":"additional","affiliation":[{"name":"Centro Universit\u00e1rio Cesmac (CESMAC)  Macei\u00f3 Alagoas Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,15]]},"reference":[{"key":"e_1_2_12_2_1","unstructured":"World Health Organization \u201cLeprosy \u201dGeneva (2026) https:\/\/www.who.int\/news\u2010room\/fact\u2010sheets\/detail\/leprosy."},{"key":"e_1_2_12_3_1","unstructured":"World Health Organization \u201cLeprosy (Hansen Disease) [Internet]. 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