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Chikungunya virus as a trigger for different renal disorders: an exploratory study

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Abstract

Introduction

Chikungunya virus was detected in cases of acute chikungunya fever in renal tissue. However, chikungunya virus-related kidney injury still lacks characterization, and it is unknown whether the kidneys are reservoirs for the virus. We sought to detect histopathological changes and viral antigens in renal tissue, and to evaluate kidney injury markers in different phases of chikungunya fever.

Methods

Two groups were evaluated in this exploratory study: patients with biopsy-proven kidney injury established after chikungunya fever, and patients with post-chikungunya fever chronic joint manifestations without known kidney injury, in whom we actively searched for kidney injury markers.

Results

In the first group, 15 patients had kidney injury 0.5–24 months after chikungunya fever. The most frequent histopathological diagnoses were glomerular lesions. No viral antigens were detected in renal tissue. High-risk genotypes were detected in patients with atypical hemolytic uremic syndrome and focal and segmental glomerulosclerosis. In the second group, 114 patients had post-chikungunya fever joint manifestations on average for 35.6 months. Mean creatinine and proteinuria were 0.9 mg/dl and 71.5 mg/day, respectively. One patient had isolated hematuria. There was no indication for renal biopsy in this group.

Conclusions

Several histopathological features were found after chikungunya fever, without virus detection in renal tissue. These findings suggest that chikungunya virus may trigger kidney lesions with varying degrees of severity at different stages of infection. However, the probability that this virus replicates in the renal tissue seems unlikely.

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Data availability

The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

We are grateful to Alexion Pharmaceuticals for the investigation of suspected cases of atypical hemolytic uremic syndrome, in the form of an emergency donation of the medication eculizumab (Soliris®) and aid in the diagnosis of genetic mutations in confirmed cases of atypical hemolytic uremic syndrome. We wish to also thank all collaborators on this project.

Funding

The authors did not receive support from any organization for the submitted work.

Author information

Authors and Affiliations

  1. Nephrology Department, Hospital das Clínicas of the Federal University of Pernambuco, Recife, Pernambuco, Brazil

    Denise Maria do Nascimento Costa, Camila Oliveira, Gisele Vajgel, Maria Alina Cavalcante & Lucila Valente

  2. University Hospital of the Federal University of Maranhão, São Luís, Maranhão, Brazil

    Carlos Eduardo Machado, Dyego José Brito, Samira Oi, Flávio Henrique Barros, Joyce Lages, Natalino Salgado Filho & Gyl Eanes Barros Silva

  3. Divisions of Nephrology and Molecular Medicine, University of São Paulo, São Paulo, São Paulo, Brazil

    Precil Diego Neves & Luiz Fernando Onuchic

  4. Virology Department, Ribeirão , Preto Medical School of the University of São Paulo, Ribeirão Preto, São Paulo, Brazil

    Luiz Tadeu Figueiredo

  5. Microscopy Center of the Federal University of Minas Gerais and Institute of Nephropathology, Belo Horizonte, Minas Gerais, Brazil

    Stanley Almeida Araujo

  6. University Hospital of the Federal University of Paraiba, João Pessoa, Paraíba, Brazil

    Francisco Ladchumananandasivam

  7. Federal University of Triângulo Mineiro, Uberaba, Minas Gerais, Brazil

    Marlene Antônia dos Reis

  8. Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil

    Weverton Luchi

  9. Rheumatology Department, Hospital das Clínicas of the Federal University of Pernambuco, Recife, Pernambuco, Brazil

    Angela Luzia Duarte & Claudia Diniz Lopes Marques

  10. Virology Division, Laboratory of Immunopathology Keizo Asami of the Federal University of Pernambuco, Recife, Pernambuco, Brazil

    Maria Rosângela Cunha Duarte Coêlho

  11. Department of Tropical Medicine, Federal University of Pernambuco, Recife, Pernambuco, Brazil

    Vera Magalhães

Authors
  1. Denise Maria do Nascimento Costa
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  2. Carlos Eduardo Machado
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  23. Gyl Eanes Barros Silva
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Contributions

Concept and design of the study: DMNC, CEEM, NSF, JSL, GEBS, LMV, VM. Data acquisition: DMNC, CEEM, DJAB, SSPO, FHSB, LTMF, SAA, FRL, MAR, WML, JSL, LFO, PDMMN, ALBPD, CDLM, MRCDC, CBLO, GV, MAGMC, LMV, GEBS. Resources, data analysis and interpretation: DMNC, GEBS, PDMMN, LFO, MRCDC, SAA, MAR. Manuscript drafting: DMNC, CEEM, LMV, VM, PDMMN, NSF, GEBS. Each author contributed important intellectual content during manuscript revision.

Corresponding author

Correspondence to Denise Maria do Nascimento Costa.

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Conflict of interest

The authors declare no conflicts of interest.

Ethical approval

This study was performed in line with the principles of the Declaration of Helsinki. The local Ethics Committee of Hospital das Clínicas da Universidade Federal de Pernambuco approved this study (CAAE 00981918.5.0000.8807, date of approval: 01 February 2019).

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Written informed consent was obtained from all the participants or legal guardians.

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do Nascimento Costa, D.M., Machado, C.E., Neves, P.D. et al. Chikungunya virus as a trigger for different renal disorders: an exploratory study. J Nephrol 35, 1437–1447 (2022). https://doi.org/10.1007/s40620-022-01256-6

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  • DOI: https://doi.org/10.1007/s40620-022-01256-6

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