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Prevalence of intestinal parasite infections and associated clinical symptoms among patients with end-stage renal disease undergoing hemodialysis

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Abstract

Purpose

Intestinal parasitic infections (IPIs) can result in high morbidity and mortality, particularly in immunocompromised patients. Infectious diseases are among the main causes of death in end-stage renal disease (ESRD) patients due to their impaired immune systems. The aim of this study was to determine the prevalence IPIs and their associated symptoms in ESRD patients.

Methods

In this case–control study, the fecal samples of 78 ESRD patients undergoing hemodialysis and 140 controls without any kidney problems were analyzed for intestinal parasites using direct-smear, formol-ether and modified Ziehl–Neelsen staining techniques.

Results

The difference in the prevalence of IPIs between ESRD patients (30.7 %) and the control group (10.7 %) was significant (OR = 3.7; 95 % CI = 1.8–7.61; P < 0.001). Blastocystis (14.1 %) and Cryptosporidium spp.(11.5 %) were the most common IPIs detected in ESRD patients, and the presence of Cryptosporidium spp. was significantly associated with diarrhea in ESRD patients (OR = 16; 95 % CI = 1.54–166.05; P < 0.05). Leukocytosis, diarrhea, weight loss, nausea/vomiting and bloating were also significantly higher in the hemodialysis group when compared with the control group.

Conclusion

The current study revealed a high prevalence of intestinal parasites and related clinical symptoms in ESRD patients undergoing hemodialysis. Since hemodialysis patients are immunocompromised and intestinal parasites can cause serious clinical complications, we suggest that stool examination for intestinal parasites, with an emphasis on detection of Cryptosporidium spp. and Blastocystis, should be incorporated into the routine clinical care for these patients. Measures for preventing the acquisition of IPIs are also recommended.

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Acknowledgments

The authors are very thankful to Professor Graham Clark (Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine) for the time generously spent in thoroughly revising the manuscript. Also, we are very grateful to the 29-Bahman hospital laboratory staffs in Tabriz city, East Azerbaijan Province, Iran, for their technical assistance. Most importantly, the authors would like to thank all the hemodialysis patients and volunteered participants for giving permission to collect samples and participated in this study. We are thankful for the collaboration of protozoology unit of the Shahid Beheshti University of Medical Sciences.

Conflict of interest

None of the above authors have any conflict of interest.

Author information

Authors and Affiliations

  1. Cellular and Molecular Biology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    V. Fallah Omrani

  2. Department of Biotechnology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    V. Fallah Omrani

  3. Department of Parasitology and Mycology, School of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran

    Sh. Fallahi

  4. Department of Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    A. Rostami, F. Hajialiani & Z. Joneidi

  5. Department of Parasitology and Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran

    A. Siyadatpanah

  6. 29-Bahman Hospital, Tabriz University of Medical Sciences, Tabriz, Iran

    Gh. Barzgarpour

  7. Department of Epidemiology and Statistics, School of Public Health, Tehran University of Medical Science, Tehran, Iran

    S. Mehravar

  8. Department of Biotechnology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran

    F. Memari

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  1. V. Fallah Omrani
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Correspondence to A. Rostami.

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Omrani, V.F., Fallahi, S., Rostami, A. et al. Prevalence of intestinal parasite infections and associated clinical symptoms among patients with end-stage renal disease undergoing hemodialysis. Infection 43, 537–544 (2015). https://doi.org/10.1007/s15010-015-0778-6

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  • DOI: https://doi.org/10.1007/s15010-015-0778-6

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