{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T03:01:24Z","timestamp":1787022084282,"version":"build-2736575974"},"reference-count":35,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2021,6,8]],"date-time":"2021-06-08T00:00:00Z","timestamp":1623110400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Visceral Leishmaniasis (VL) is a neglected tropical disease endemic to several countries including Ethiopia. Outside of Africa, kidney involvement in VL is frequent and associated with increased mortality. There is however limited data on acute kidney injury (AKI) in VL patients in East-Africa, particularly in areas with high rates of HIV co-infection. This study aims to determine the prevalence, characteristics and associated factors of AKI in VL patients in Northwest Ethiopia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A hospital based retrospective patient record analysis was conducted including patients treated for VL from January 2019 to December 2019 at the Leishmaniasis Research and Treatment Center (LRTC), Gondar, Ethiopia. Patients that were enrolled in ongoing clinical trials at the study site and those with significant incomplete data were excluded. Data was analyzed using SPSS version 20.\n                      <jats:italic>P<\/jats:italic>\n                      values were considered significant if &lt; 0.05.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 352 VL patients treated at LRTC during the study period, 298 were included in the study. All were male patients except two; the median age was 23 years (IQR: 20\u201327). The overall prevalence of AKI among VL patients was 17.4% (confidence interval (CI): 13.6%-22.2%). Pre-renal azotemia (57%) and drug-induced AKI (50%) were the main etiologies of AKI at admission and post-admission respectively. Proteinuria and hematuria occurred in 85% and 42% of AKI patients respectively. Multivariate logistic regression revealed HIV co-infection (adjusted odds ratio (AOR): 6.01 95% CI: 1.99\u201318.27, p = 0.001) and other concomitant infections (AOR: 3.44 95% CI: 1.37\u20138.65, p = 0.009) to be independently associated with AKI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>AKI is a frequent complication in Ethiopian VL patients. Other renal manifestations included proteinuria, hematuria, and pyuria. HIV co-infection and other concomitant infections were significantly associated with AKI. Further studies are needed to quantify proteinuria and evaluate the influence of AKI on the treatment course, morbidity and mortality in VL patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0252419","type":"journal-article","created":{"date-parts":[[2021,6,8]],"date-time":"2021-06-08T14:00:21Z","timestamp":1623160821000},"page":"e0252419","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":11,"title":["Acute kidney injury in patients with Visceral Leishmaniasis in Northwest Ethiopia"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0149-4471","authenticated-orcid":true,"given":"Workagegnehu","family":"Hailu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rezika","family":"Mohamed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helina","family":"Fikre","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saba","family":"Atnafu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Azeb","family":"Tadesse","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ermias","family":"Diro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johan","family":"van Grienvsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,6,8]]},"reference":[{"issue":"8","key":"pone.0252419.ref001","doi-asserted-by":"crossref","first-page":"e00723","DOI":"10.1016\/j.heliyon.2018.e00723","article-title":"Leishmaniasis in Ethiopia: A systematic review and meta-analysis of prevalence in animals and humans","volume":"4","author":"A Assefa","year":"2018","journal-title":"Heliyon"},{"key":"pone.0252419.ref002","unstructured":"WHO. Leishmaniasis key facts [Internet]. 2020. Available from: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/leishmaniasis. Accessed on March 7,2021."},{"key":"pone.0252419.ref003","unstructured":"WHO. Epidemiological situation of leishmaniasis. In 2017. Available from: https:\/\/www.who.int\/leishmaniasis\/burden\/en\/. Accessed 12 June 2019"},{"key":"pone.0252419.ref004","unstructured":"WHO. Report on interregional meeting on leishmaniasis among neighbouring endemic countries in the Eastern Mediterranean, African and European regions. 2019; Available from: https:\/\/www.who.int\/leishmaniasis\/resources\/who-em-ctd-081-e\/en\/. Accessed on 12 June 2019"},{"issue":"1","key":"pone.0252419.ref005","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13071-015-0987-y","article-title":"Eco-epidemiology of visceral leishmaniasis in Ethiopia","volume":"8","author":"E Gadisa","year":"2015","journal-title":"Parasites and Vectors"},{"key":"pone.0252419.ref006","first-page":"556","volume-title":"Epidemiology and Ecology of Health and Disease in Ethiopia, Ethiopia","author":"A Hailu","year":"2006"},{"issue":"4","key":"pone.0252419.ref007","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1016\/j.bjid.2013.11.013","article-title":"Kidney involvement in leishmaniasis-A review","volume":"18","author":"GB da Silva Junior","year":"2014","journal-title":"Brazilian J Infect Dis"},{"issue":"3","key":"pone.0252419.ref008","doi-asserted-by":"crossref","first-page":"449","DOI":"10.4269\/ajtmh.2010.09-0571","article-title":"Risk factors for acute kidney injury in visceral leishmaniasis (Kala-Azar)","volume":"82","author":"MJC Oliveira","year":"2010","journal-title":"Am J Trop Med Hyg"},{"issue":"3","key":"pone.0252419.ref009","first-page":"147","article-title":"Renal involvement in leishmaniasis: A review of the literature","volume":"4","author":"A Clementi","year":"2011","journal-title":"NDT Plus"},{"issue":"1","key":"pone.0252419.ref010","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1016\/S0272-6386(85)80034-2","article-title":"Renal Involvement in Visceral Leishmaniasis","volume":"6","author":"M Dutra","year":"1985","journal-title":"Am J Kidney Dis"},{"key":"pone.0252419.ref011","volume-title":"Comprehensive Clinical Nephrology","author":"Jurgen Floege","year":"2010","edition":"4"},{"issue":"3","key":"pone.0252419.ref012","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1016\/j.ekir.2016.06.003","article-title":"Leishmaniasis-Associated Membranoproliferative Glomerulonephritis With Massive Complement Deposition","volume":"1","author":"S Sethi","year":"2016","journal-title":"Kidney Int Reports"},{"issue":"7","key":"pone.0252419.ref013","first-page":"546","article-title":"Acute renal failure as initial presentation of visceral leishmaniasis in an HIV-1-infected patient. sccnd","volume":"34","author":"P Clevenbergh","year":"2002","journal-title":"J infect Dis"},{"issue":"3","key":"pone.0252419.ref014","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1007\/s40261-016-0481-0","article-title":"Safety and Effectiveness of Sodium Stibogluconate and Paromomycin Combination for the Treatment of Visceral Leishmaniasis in Eastern Africa: Results from a Pharmacovigilance Programme","volume":"37","author":"R Kimutai","year":"2017","journal-title":"Clin Drug Investig"},{"issue":"11","key":"pone.0252419.ref015","first-page":"180","article-title":"Severe adverse reactions to meglumine antimoniate in the treatment of visceral leishmaniasis: a report of 13 cases in the southwestern region of Brazil","volume":"39","author":"A Lu","year":"2009","journal-title":"Trop Doct"},{"key":"pone.0252419.ref016","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1093\/jac\/49.suppl_1.37","article-title":"Amphotericin B nephrotoxicity","volume":"49","author":"G Deray","year":"2002","journal-title":"J Antimicrob Chemother"},{"issue":"2","key":"pone.0252419.ref017","doi-asserted-by":"crossref","first-page":"209","DOI":"10.4269\/ajtmh.2009.81.209","article-title":"Buffet PA TP. AA-amyloidosis caused by visceral leishmaniasis in a human immunodeficiency virus-infected patient","volume":"81","author":"S de Valli\u00e8re","year":"2009","journal-title":"Am J Trop Med Hyg"},{"issue":"1","key":"pone.0252419.ref018","doi-asserted-by":"crossref","first-page":"9","DOI":"10.4269\/ajtmh.1975.24.9","article-title":"Glomerular involvement in human kala-azar. A light, immunofluorescent, and electron microscopic study based on kidney biopsies","volume":"24","author":"T DE Brito","year":"1975","journal-title":"Am J Trop Med Hyg"},{"issue":"4","key":"pone.0252419.ref019","first-page":"531","volume":"77","author":"MI Duarte","year":"1983","journal-title":"Interstitial nephritis in human kala-azar"},{"issue":"4","key":"pone.0252419.ref020","doi-asserted-by":"crossref","first-page":"586","DOI":"10.1681\/ASN.2011050472","article-title":"Renal leishmaniasis as unusual cause of nephrotic syndrome in an HIV patient","volume":"23","author":"K Amann","year":"2012","journal-title":"J Am Soc Nephrol"},{"key":"pone.0252419.ref021","doi-asserted-by":"crossref","first-page":"8","DOI":"10.12659\/AJCR.892641","article-title":"Membranoproliferative glomerulonephritis due to visceral leishmaniasis in an HIV patient","volume":"16","author":"R Enr\u00edquez","year":"2015","journal-title":"Am J Case Rep"},{"issue":"11","key":"pone.0252419.ref022","doi-asserted-by":"crossref","DOI":"10.1016\/j.trstmh.2010.07.007","article-title":"Safety and effectiveness of meglumine antimoniate in the treatment of Ethiopian visceral leishmaniasis patients with and without HIV co-infection","volume":"104","author":"W Hailu","year":"2010","journal-title":"Trans R Soc Trop Med Hyg"},{"key":"pone.0252419.ref023","unstructured":"https:\/\/clinicaltrials.gov\/ct2\/show\/NCT03129646."},{"issue":"1","key":"pone.0252419.ref024","first-page":"3","article-title":"KDIGO Clinical Practice Guideline for Acute Kidney Injury","volume":"2","author":"ISN","year":"2012","journal-title":"Kidney Int"},{"issue":"1","key":"pone.0252419.ref025","first-page":"1","article-title":"Spectrum Of Renal Disease In Visceral Leishmaniasis","volume":"4","author":"J Prakash","year":"2006","journal-title":"Internet J Trop Med"},{"issue":"4","key":"pone.0252419.ref026","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1590\/S1413-86702008000400015","article-title":"Clinical presentation and renal evaluation of human visceral leishmaniasis (kala-azar): a retrospective study of 57 patients in Brazil","volume":"12","author":"EF Daher","year":"2008","journal-title":"Braz J Infect Dis"},{"issue":"5","key":"pone.0252419.ref027","doi-asserted-by":"crossref","DOI":"10.1097\/INF.0b013e3182814eae","article-title":"Comparative analysis of pediatric and adult visceral leishmaniasis in Brazil","volume":"32","author":"NA Rocha","year":"2013","journal-title":"Pediatr Infect Dis J"},{"key":"pone.0252419.ref028","first-page":"43","article-title":"Renal involvement in kala-azar","volume":"95","author":"LS Prasad","year":"1992","journal-title":"Indian J Med Res"},{"issue":"2","key":"pone.0252419.ref029","first-page":"217","article-title":"Involvement of the renal function in patients with visceral leishmaniasis (kala-azar)","volume":"36","author":"N Salgado Filho","year":"2003","journal-title":"Rev Soc Bras Med Trop"},{"issue":"5","key":"pone.0252419.ref030","first-page":"872","article-title":"Surrogate markers of subtle renal injury in patients with visceral leishmaniasis","volume":"21","author":"NA Elnojomi","year":"2010","journal-title":"Saudi J Kidney Dis Transpl"},{"issue":"42","key":"pone.0252419.ref031","first-page":"383","article-title":"Renal dysfunction in patients of kala azar treated with sodium antimony gluconate","volume":"5","author":"US Rai","year":"1994","journal-title":"J Assoc Physicians India"},{"issue":"2","key":"pone.0252419.ref032","doi-asserted-by":"crossref","first-page":"357","DOI":"10.4269\/ajtmh.1978.27.357","article-title":"Clinical and histological kidney involvement in human kala-azar","volume":"27","author":"JR Weisinger","year":"1978","journal-title":"Am J Trop Med Hyg"},{"issue":"06","key":"pone.0252419.ref033","doi-asserted-by":"crossref","first-page":"370","DOI":"10.5414\/CN108195","article-title":"Glomerulonephritis and cryoglobulinemia: first manifestation of visceral leishmaniasis","volume":"83","author":"M Ortiz","year":"2015","journal-title":"Clin Nephrol"},{"issue":"7","key":"pone.0252419.ref034","doi-asserted-by":"crossref","first-page":"848","DOI":"10.1111\/j.1365-3156.2010.02550.x","article-title":"Clinical characteristics and treatment outcome of patients with visceral leishmaniasis and HIV co-infection in northwest Ethiopia","volume":"15","author":"Z Hurissa","year":"2010","journal-title":"Trop Med Int Heal"},{"issue":"8","key":"pone.0252419.ref035","doi-asserted-by":"crossref","first-page":"733","DOI":"10.1046\/j.1365-3156.2003.01088.x","article-title":"Visceral leishmaniasis and HIV in Tigray, Ethiopia","volume":"8","author":"S Lyons","year":"2003","journal-title":"Trop Med Int Heal"}],"updated-by":[{"DOI":"10.1371\/journal.pone.0306663","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2024,7,2]],"date-time":"2024-07-02T00:00:00Z","timestamp":1719878400000}}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0252419","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,6,8]],"date-time":"2021-06-08T14:00:57Z","timestamp":1623160857000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0252419"}},"subtitle":[],"editor":[{"given":"Andrea L.","family":"Conroy","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2021,6,8]]},"references-count":35,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2021,6,8]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0252419","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6,8]]}}}