Use of probiotics in patients with chronic kidney disease on hemodialysis: a randomized clinical trial / Uso de probióticos em pacientes com doença renal crônica em hemodiálise: um ensaio clínico randomizado

ABSTRACT Introduction: Supplementation with probiotics for patients with chronic kidney disease (CKD) may be associated with decreased systemic inflammation. Objective: To assess the impact of oral supplementation with probiotics for patients with CKD on hemodialysis. Method: This double-blind randomized clinical trial included 70 patients on hemodialysis; 32 were given oral supplementation with probiotics and 38 were in the placebo group. Blood samples were collected at the start of the study and patients were given oral supplementation with probiotics or placebo for three months. The probiotic supplement comprised four strains of encapsulated Gram-positive bacteria: Lactobacillus Plantarum A87, Lactobacillus rhamnosus, Bifidobacterium bifidum A218 and Bifidobacterium longum A101. Patients were given one capsule per day for 3 months. Blood samples were taken throughout the study to check for inflammatory biomarkers. Non-traditional biomarkers Syndecan-1, IFN-y, NGAL, and cystatin C were measured using an ELISA kit, along with biochemical parameters CRP, calcium, phosphorus, potassium, PTH, GPT, hematocrit, hemoglobin, glucose, and urea. Results: Patients given supplementation with probiotics had significant decreases in serum levels of syndecan-1 (239 ± 113 to 184 ± 106 ng/mL, p = 0.005); blood glucose levels also decreased significantly (162 ± 112 to 146 ± 74 mg/dL, p = 0.02). Conclusion: Administration of probiotics to patients with advanced CKD was associated with decreases in syndecan-1 and blood glucose levels, indicating potential improvements in metabolism and decreased systemic inflammation.

Resumo Introdução: A suplementação com probióticos na doença renal crônica (DRC) pode estar associada à redução do processo inflamatório sistêmico. Objetivo: Avaliar a suplementação oral com probióticos em pacientes com DRC em hemodiálise. Método: Ensaio clínico, duplo cego, randomizado com 70 pacientes em hemodiálise, sendo 32 do grupo que recebeu o suplemento de probióticos e 38 do grupo placebo. Inicialmente ocorreu a coleta de sangue e suplementação oral com probióticos ou placebo durante três meses. O suplemento probiótico foi composto pela combinação de 4 cepas de bactérias Gram-positivas encapsuladas: Lactobacillus Plantarum A87, Lactobacillus rhamnosus, Bifidobacterium bifidum A218 e Bifidobacterium longum A101, sendo 1 cápsula do suplemento ao dia, durante 3 meses. Após esse período foram feitas novas coletas de sangue para dosagem dos biomarcadores inflamatórios. Foram analisados os biomarcadores não tradicionais: Syndecan-1, IFN-y, NGAL e cistatina C pelo método ELISA, e os seguintes parâmetros bioquímicos: PCR, cálcio, fósforo, potássio, PTH, TGP, hematócrito, hemoglobina, glicose e ureia. Resultados: Os pacientes que receberam suplemento tiveram diminuição significativa dos níveis séricos de syndecan-1 (de 239 ± 113 para 184 ± 106 ng/mL, p = 0,005). Outro parâmetro que diminuiu significativamente nos pacientes que receberam suplemento foi a glicemia (de 162 ± 112 para 146 ± 74 mg/dL, p = 0,02). Conclusão: O uso de probióticos na DRC avançada esteve associado à redução dos níveis de syndecan-1 e glicemia, sinalizando possível melhora no metabolismo e redução do processo inflamatório sistêmico.

Association between Adiposity Indexes and Kidney Disease: Findings from the Longitudinal Study of Adult Health (Elsa-Brazil).

INTRODUCTION: Chronic kidney disease (CKD) is a public health problem and it is associated with a high risk of mortality. Overweight and obesity are known as independent risk factors for CKD. OBJECTIVE: To investigate the association between adiposity indexes and kidney disease. METHODS: This study included 14,636 adults from ELSA-Brazil. Outcome variables: altered glomerular filtration rate (GFR), categorized as yes (GFR <60 mL/min/1.73 m2) and no (GFR ≥60 mL/min/1.73 m2), albuminuria, estimated by albumin-creatinine ratio and categorized as yes (≥30 mg/g) and no (<30 mg/g), and presence of chronic kidney disease (CKD) (altered GFR and/or albuminuria). Exposure variables: obesity and overweight (body mass index (BMI)≥30 and ≥25 kg/m2, respectively), high waist circumference (WC) (≥102 cm in men and ≥88 cm in women), high waist-to-hip ratio (WHR) (≥0.90 in men and ≥0.85 in women), and high waist-to-height ratio (WHtR) (≥0.5). To estimate the association between main exposures and outcomes, logistic regression analyses were performed using models adjusted for sociodemographic variables (age, gender, race/skin color, education), behavioral (smoking, physical activity, alcohol consumption), components of the metabolic syndrome (HDL cholesterol, triglycerides, hypertension, diabetes mellitus) and history of cardiovascular disease (myocardial infarction, angina or heart failure). RESULTS: Individuals with obesity, high WC, WHR and WHtR were more prone to albuminuria when compared to individuals with normal values for these measures. It was also observed that these altered measures were positively associated with the presence of CKD. CONCLUSION: Adiposity indexes have a direct and significant association with albuminuria and CKD.

Intraoperative systemic biomarkers predict post-liver transplantation acute kidney injury.

OBJECTIVE: Liver transplant (LT) is a definitive therapeutic option for patients with chronic liver disease. However, acute kidney injury after LT (post-LT AKI) is a frequent complication that may lead to graft dysfunction and decrease life expectancy. Delay in AKI detection by traditional biomarkers boosted research with new biomarkers for post-LT AKI as neutrophil gelatinase-associated lipocalin (NGAL) and syndecan-1. We aim to evaluate associations of intraoperative systemic NGAL and syndecan-1 levels with post-LT AKI. METHODS: This is a prospective study conducted in 46 patients selected for LT. Patients were evaluated preoperatively and blood samples were collected intraoperatively: T1 (after induction of anesthesia), T2 (anhepatic phase) and T3 (2 h after reperfusion of the graft). RESULTS: The mean age was 54 ± 12 years and 60% were male. Post-LT AKI was observed in 24 (52%) patients of which 12% needed dialysis. Serum NGAL and syndecan-1 increased along surgical phases. Mostly, increment values of serum NGAL of T2 to T3 and syndecan-1 at T3 were importantly associated with post-LT AKI. Into a multivariate model with model for end-stage liver disease score, age, gender, warm ischemia, cold ischemia and surgery time, syndecan-1 levels at T3 remains capable to predict post-LT AKI. Serum NGAL had significance only with increment values calculated by the ratio of 'T3/T2'. Finally, serum syndecan-1 at T3 had a better diagnostic performance in receiver operating characteristic curve analysis. CONCLUSION: Serum syndecan-1 levels in 2 h after reperfusion were most useful in early post-LT AKI diagnosis and may be used to construct new risk groups in this context.

Non-invasive urinary biomarkers of renal function in sickle cell disease: an overview.

Sickle cell disease (SCD) is a hereditary condition characterized by homozygosis of the hemoglobin S (HbS) gene. Marked morbimortality is observed due to chronic hemolysis, endothelial injury, and episodes of vaso-occlusion, which leads to multi-organ damage. Renal impairment is common and may have different presentations, such as deficiency in urinary acidification or concentration, glomerulopathies, proteinuria, and hematuria, frequently resulting in end-stage renal disease (ESRD). Novel biomarkers of renal function, such as kidney injury molecule 1 (KIM-1), and neutrophil gelatinase-associated lipocalin (NGAL) and monocyte chemoattractant protein 1 (MCP-1) are being studied in order to enable early diagnosis of kidney damage in SCD.

Acute Kidney Injury Induced by Bothrops Venom: Insights into the Pathogenic Mechanisms.

Acute kidney injury (AKI) following snakebite is common in developing countries and Bothrops genus is the main group of snakes in Latin America. To evaluate the pathogenic mechanisms associated with Bothrops venom nephrotoxicity, we assessed urinary and blood samples of patients after hospital admission resulting from Bothrops snakebite in a prospective cohort study in Northeast Brazil. Urinary and blood samples were evaluated during hospital stay in 63 consenting patients, divided into AKI and No-AKI groups according to the KDIGO criteria. The AKI group showed higher levels of urinary MCP-1 (Urinary monocyte chemotactic protein-1) (median 547.5 vs. 274.1 pg/mgCr; p = 0.02) and urinary NGAL (Neutrophil gelatinase-associated lipocalin) (median 21.28 vs. 12.73 ng/mgCr; p = 0.03). Risk factors for AKI included lower serum sodium and hemoglobin levels, proteinuria and aPTT (Activated Partial Thromboplastin Time) on admission and disclosed lower serum sodium (p = 0.01, OR = 0.73, 95% CI: 0.57⁻0.94) and aPTT (p = 0.031, OR = 26.27, 95% CI: 1.34⁻512.11) levels as independent factors associated with AKI. Proteinuria showed a positive correlation with uMCP-1 (r = 0.70, p < 0.0001) and uNGAL (r = 0.47, p = 0.001). FENa (Fractional Excretion of sodium) correlated with uMCP-1 (r = 0.47, P = 0.001) and uNGAL (r = 0.56, p < 0.0001). sCr (serum Creatinine) showed a better performance to predict AKI (AUC = 0.85) in comparison with new biomarkers. FEK showed fair accuracy in predicting AKI (AUC = 0.92). Coagulation abnormality was strongly associated with Bothrops venom-related AKI. Urinary NGAL and MCP-1 were good biomarkers in predicting AKI; however, sCr remained the best biomarker. FEK (Fractional Excretion of potassium) emerged as another diagnostic tool to predict early AKI. Positive correlations between uNGAL and uMCP-1 with proteinuria and FENa may signal glomerular and tubular injury. Defects in urinary concentrations highlighted asymptomatic abnormalities, which deserve further study.

Common mental disorders among workers chronically exposed to pesticides: the case of workers involved in fighting endemic diseases.

BACKGROUND: Common mental disorders are a considerable global public health concern and pose a high burden of disease especially in terms of years lived with disability (YLD). OBJECTIVE: To establish the prevalence of common mental disorders among workers involved in fighting endemic diseases in the state of Ceará, Brazil. METHODS: In the present cross-sectional study we administered the Self-Reporting Questionnaire 20, a screening tool for common mental disorders previously validated for use in Brazil. To calculate the sample size we considered the total number of workers involved in fighting endemic diseases in Fortaleza and four metropolitan municipalities. RESULTS: About 33.3% of the participants met the criteria for common mental disorders. The questionnaire section on depressive and anxiety symptoms exhibited the highest frequency of affirmative answers. The prevalence ratio was highest for the participants in Caucaia (PR=2.13). CONCLUSION: The results indicate a previously unknown and considerable morbidity profile. The present was the first study that investigated common mental disorders in this occupational group.

INTRODUÇÃO: Os transtornos mentais comuns correspondem a importantes problemas de saúde pública e conferem alta carga de doença. OBJETIVO: Investigar a prevalência de transtornos mentais comuns nos agentes de combate a endemias no estado do Ceará. MÉTODOS: Foi realizado estudo de corte transversal, com instrumento de rastreio para transtornos mentais comuns validado no Brasil, o Self-Reporting Questionnaire (SRQ-20). Para o cálculo do tamanho da amostra, foi considerado o número total de trabalhadores ocupantes do cargo de agente de combate a endemias lotados em Fortaleza e em quatro municípios da região metropolitana. RESULTADOS: Foi identificado que 33,3% dos trabalhadores apresentaram critérios para transtornos mentais comuns. As respostas mais prevalentes corresponderam ao bloco de perguntas dos componentes humor ansioso e depressivo. Os trabalhadores que labutam no município de Caucaia apresentaram razão de prevalência superior para desenvolver transtornos mentais comuns (razão de prevalência - RP=2,13) quando comparados aos agentes de combate a endemias lotados nos outros municípios. CONCLUSÃO: Os resultados desta pesquisa evidenciaram um perfil de morbidade importante e até então desconhecido. Este estudo é pioneiro na investigação de transtornos mentais comuns no tocante aos trabalhadores da saúde pública expostos a agrotóxicos utilizados nas campanhas de combate a vetores.

Doença renal crônica: explorando novas estratégias de comunicação para promoção da saúde / Chronic Kidney Disease: exploring new strategies of communication for health promotion / Enfermedad renal crónica: explorando nuevas estrategias de comunicación para la promoción de la salud

OBJETIVO: Descrever o desenvolvimento de novas estratégias de comunicação para promoção da saúde no âmbito da doença renal crônica (DRC). MÉTODOS: Pesquisa de natureza aplicada, pois objetiva a produção de conhecimentos direcionados à solução de problemas específicos por meio de ferramentas práticas e da análise das hipóteses levantadas. As ferramentas foram desenvolvidas pela parceria entre o Programa de Pós-Graduação em Saúde Coletiva e o Núcleo de Aplicação em Tecnologia da Informação da Universidade de Fortaleza. O estudo intitulado "Renal Health" foi dividido em três fases consecutivas: Fase 1 - Desenvolvimento do aplicativo Renal Health; Fase 2 - Construção de conteúdos e plataformas digitais vinculadas ao aplicativo; e Fase 3 ­ Teste de impacto clínico e adesão ao aplicativo. No presente momento, o estudo encontra-se com a fase 1 concluída e com a fase 2 em andamento. RESULTADOS: Foi desenvolvido o aplicativo Renal Health para uso em dispositivos móveis, em plataforma Android, com interfaces para a população geral, ou seja, pessoas que não fazem tratamento para DRC, pacientes renais crônicos em hemodiálise e transplantados renais. A fase 2 do estudo encontra-se em desenvolvimento, ocorrendo por meio de reuniões entre as equipes de pesquisadores e dos setores saúde e tecnologia para a compilação dos conteúdos e delineamento do projeto gráfico das plataformas digitais. CONCLUSÃO: A comunicação entre os profissionais de saúde e os portadores de DRC é passível de contínuo aperfeiçoamento, dada a variedade das modalidades de tratamento e suas peculiaridades. O aplicativo Renal Health e as plataformas digitais se propõem a apoiar ambos nesse processo.

OBJECTIVE: To describe the development of new communication strategies for health promotion in the context of chronic kidney disease (CKD). METHODS: This is an applied research aimed at producing knowledge to solve specific problems through practical tools and analysis of hypotheses. The tools were developed through a partnership between the Public Health Graduate Program and the Center of Applied Information Technology of the University of Fortaleza. The study titled "Renal Health" was divided into three consecutive phases: Phase 1 ­ Development of the Renal Health application; Phase 2 ­ Elaboration of digital content and platforms linked to the application; and Phase 3 ­ Tests of clinical impact and adherence to the application. Phase 1 was finished and phase 2 is currently ongoing. RESULTS: The Renal Health application was developed to be used in Android mobile phones and features interfaces targeted at the general population, i.e., people who do not receive CKD treatment, CKD patients undergoing hemodialysis and kidney transplant patients. Phase 2 of the study is being carried out through meetings between researchers and health and technology teams to develop the content and design the graphical project of the digital platforms. CONCLUSION: Communication between health professionals and CKD patients is subjected to continuous improvement given the variability of treatment modalities and its peculiarities. The Renal Health application and digital platforms intend to support both professionals and patients in this process.

OBJETIVO: Describir el desarrollo de nuevas estrategias de comunicación para la promoción de la salud en el ámbito de la Enfermedad Renal Crónica (ERC). MÉTODOS: Investigación de naturaleza aplicada pues tiene el objetivo de producir conocimientos dirigidos para la solución de problemas específicos a través de herramientas prácticas y del análisis de las hipótesis presentadas. Las herramientas han sido desarrolladas con la colaboración entre el Programa de Pos-Grado de Salud Colectiva y el Núcleo de Aplicación en Tecnología de la Información de la Universidad de Fortaleza. El estudio intitulado "Renal Health" ha sido dividido en tres fases consecutivas: Fase 1 ­ Desarrollo del aplicativo Renal Health; Fase 2 ­ Construcción de contenidos y plataformas digitales vinculadas al aplicativo; y Fase 3 ­ Prueba de impacto clínico y adhesión al uso del aplicativo. En el momento el estudio está con la fase 1 concluida y la fase 2 en seguimiento. RESULTADOS: Ha sido desarrollado el aplicativo Renal Health para dispositivos móviles, en la plataforma Android, con interfaces para la población general, o sea, personas que no tiene el tratamiento para la ERC, pacientes renales crónicos en hemodiálisis y trasplantados renales. Se está desarrollando la fase 2 del estudio con reuniones entre los equipos de investigadores y los sectores de salud y tecnología para la compilación de los contenidos y delineamiento del proyecto gráfico de las plataformas digitales. CONCLUSIÓN: La comunicación entre los profesionales sanitarios y los portadores de ERC es pasible de perfeccionamiento continuo por la variedad de modalidades de tratamiento y sus peculiaridades. El aplicativo Renal Health y las plataformas digitales se proponen a apoyarse en ese proceso.

Kyrle's disease associated with HIV infection, diabetes, and chronic kidney disease.

Kyrle's disease (KD) is a rare skin pathology characterized by transepidermal elimination of abnormal keratin. The aim of this article is to report a rare case of KD associated with diabetes mellitus, chronic kidney disease, and HIV. A 51-year-old male patient complained of diarrhea for 8 months. He was submitted to HIV testing, which showed a positive result. He started antiretroviral therapy with zidovudine, lamivudine, and lopinavir. The diagnostic investigation was negative for opportunistic diseases. After 2 months, skin lesions started appearing, characterized by hyperchromic, pruritic macules and papules distributed in the trunk, back, and upper limbs. He also developed erythematous, scaly lesions in the facial region. A biopsy of the skin was performed, of which histopathological report consisted of perforating disorder, favoring a diagnosis of KD. Treatment with keratolytic soap (Actine) was started, with skin lesion improvement. In this reported case, it is possible that, in addition to diabetes and renal failure, HIV infection played an important role in the genesis of the lesions.

Rede de relações em um serviço de atendimento móvel de urgência: análise de uma equipe de trabalho / Relationship network at a mobile urgent care service unit: analysis of a work team

Introdução: Os profissionais que trabalham no Serviço de Atendimento Móvel de Urgência (SAMU) lidam com situações extremas, as quais exigem altas demandas psicológicas. Objetivo: Investigar as redes de relações entre trabalhadores do SAMU-Ceará, no Nordeste do Brasil. Método: Trata-se de um estudo de caso de natureza qualitativa, em que foram feitas entrevistas semiestruturadas com uma equipe do SAMU-Ceará. Primeiramente, para traçar as redes de relacionamento, foram entrevistados três profissionais do serviço, entre médicos e enfermeiros. Com base nessas entrevistas, entrevistaram-se mais dois trabalhadores, que foram citados pelos entrevistados anteriores. Para a análise textual dos discursos obtidos, foi empregado o programa Interface de R pour lês Analyses Multidimensionnelles de Textes et de Questionnaires (iRaMuTeQ). As características estruturais da rede, como tamanho e densidade, foram conferidas pelos softwares UCINET 6.123 e NetDraw 2.38. Resultados: Os entrevistados estavam no serviço havia pelo menos um ano. As conexões configuradas com base nas entrevistas evidenciaram a inter-relação entre as redes dos entrevistados, e observamos a prevalência de vínculos fracos e desarticulados, muito embora dois dos entrevistados trabalhassem no mesmo setor. Na análise dos discursos, obtivemos três classes: 1) características do trabalho em equipe e sua forma peculiar de execução; 2) aspectos relacionais e subjetivos voltados para a administração; 3) natureza dos serviços prestados. Conclusões: As redes sociais no SAMUCeará expressam um conjunto de colaboradores que se relacionam para responder às demandas dos usuários de maneira integrada, tentando respeitar a autonomia de cada um, contudo as redes revelam conflitos, ocasionando sofrimento psíquico no trabalho

Introduction: Professionals at the Mobile Urgent Care Service (Serviço de Atendimento Móvel de Urgência ­ SAMU) face extreme situations which pose high psychological demands. Objective: To investigate networks of relationships among employees of SAMU-Ceará, in Northeastern Brazil. Methods: Case study of qualitative nature in which we conducted semi-structured interviews with SAMU-Ceará staff. To draw the relationship network, we first interviewed three professionals including physicians and nurses. Based on their narratives, we interviewed two further employees named by the former. We used program Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires (iRaMuTeQ) for textual analysis of the narratives obtained. Structural network characteristics, such as size and density, were analyzed with software UCINET 6.123 and NetDraw 2.38. Results: The interviewees had worked at the service for one year at least. The connections identified based on the interviews evidenced interrelationship between networks involving the interviewees. The links found were weak and unarticulated, even though two interviewees worked in the same department. Discourse analysis yielded three classes: 1) teamwork characteristics and peculiar ways to execute work; 2) relational and subjective aspects centered on management; and 3) nature of the service delivered. Conclusions: The social networks at SAMU-Ceará represent a set of workers who establish mutual relationships to satisfy the demands and needs of service users in an integrated manner while attempting to respect the knowledge and autonomy of each member. Nevertheless, the networks evidenced conflict which is a cause of mental suffering at work.

The experience of male spouses in the context of breast cancer: a systematic review of the literature.

The purpose of this systematic review is to look into how the experience of husbands of women treated for breast cancer is approached in the literature. Between July and August 2015, the databases of PubMed, SciELO and BIREME were searched for papers published in the period January 2005-July 2015; a final sample of 23 papers was defined. The studies listed several negative and positive aspects of the experience, such as financial difficulties, psychological distress, lack of coping skills among family members, social recognition of the role of caregiver, acquisition of new responsibilities and the maturing of family members.

Acute kidney injury due to excessive and prolonged intramuscular injection of veterinary supplements containing vitamins A, D and E: A series of 16 cases.

BACKGROUND: Despite well-documented risks, injectable supplements containing high doses of vitamins are commonly used. OBJECTIVES: To describe acute kidney injury (AKI) as a complication of vitamin intoxication. METHODS: Our series consisted of 16 patients with kidney complications resulting from the use of veterinary intramuscular injection supplements of vitamin A, D and E. The patients were admitted to two referral hospitals in Fortaleza (Brazil) between January 2010 and January 2015. RESULTS: Patients' mean age was 28.3±8.9 years (19-53 years), and 11 (68.7%) were male. Main signs and symptoms upon admission were nausea (68.7%), vomiting (62.5%), weight loss (43.7%), epigastric pain (31.2%) and headache (31.2%). At hospital admission the mean laboratory values were: hemoglobin 10±2.0g/dL (6.1-14.2), leukocytes 10,542±4871/mm3 (4100-15,100), creatinine 3.9±5.2mg/dL (0.7-22) and urea 91±88mg/dL (22-306), respectively. Serum calcium was 12±2.2mg/dL (8.8-15.5), 24-h urine calcium was 575±329mg (10.7-1058), serum PTH was 55±141pg/mL (2-406), and serum vitamin D concentration was 135±75ng/mL (22-265). Using KDIGO criteria, AKI was diagnosed in 13 patients (81.2%), classified as stage 1 (n=3), stage 2 (n=3) or stage 3 (n=7). No deaths occurred in the study period. CONCLUSIONS: Excessive use of veterinary vitamin supplements containing high doses of vitamin A, D and E was associated with AKI. Hypercalcaemia, which was a common finding, appears to be a contributing factor to the development of this type of AKI.

Tuberculosis-associated chronic kidney disease.

Extrapulmonary tuberculosis (TB) account for approximately 15-20% of TB cases in immunocompetent patients. The genitourinary system is the third most commonly affected site. We report the case of a 20-year-old man admitted with fever, chills, dry cough, right flank pain, and oliguria who developed renal function loss. The pyelogram evidenced silence of the right kidney, and the abdominal and pelvic magnetic resonance showed significant dilation of the right pyelocaliceal system and proximal ureter. Biopsies of renal cortex and retroperitoneal lymph nodes showed caseous granuloma consistent with TB. Treatment was started with rifampicin, isoniazid, pyrazinamide, and ethambutol, and the patient presented a favorable outcome but with non-dialytic chronic kidney disease. This case illustrates a case of chronic kidney disease secondary to TB in a young, otherwise healthy man.

Renal involvement in leprosy: retrospective analysis of 461 cases in Brazil.

BACKGROUND: Renal lesions in leprosy have been extensively described, including amyloidosis, glomerulonephritis, nephrosclerosis, tubulointerstitial nephritis and granulomas. MATERIAL AND METHODS: A retrospective study was designed to detect renal function abnormalities in 461 leprosy patients, without any co-morbidity, seen in a university hospital in northeast Brazil. The laboratory test results concerning renal function were examined in the patients' medical records. RESULTS: The mean age was 39 +/- 18 years and 217 (47%) were male. The mean duration of disease was 21 +/- 38 months. Levels of creatinine above 1.4 mg/dL had been detected in 40 patients (8.6%). The levels of creatinine and urea were higher in lepromatous leprosy patients. Proteinuria, hematuria and hemoglobinuria were significantly more frequent in this presentation of leprosy. Nephrotic levels of proteinuria (>3.5 mg/dL) were found in three (2.1%) of 138 lepromatous leprosy patients. A positive association was found between duration of disease and high levels of creatinine in the general sample and in the lepromatous leprosy patients. There was no association between time of treatment and high levels of creatinine. CONCLUSION: Renal involvement in leprosy seems to be related to the quantity of bacilli present in the body. It is important to evaluate the renal function in all leprosy patients in order to detect any abnormality and prevent renal failure, which is still a potential cause of death in this disease.