• Aditya Narvekar

Microbial infections in kidney diseases

Microbes are tiny living things that are found all around us and are too small to be seen by the naked eye. They live in water, soil, and air. Microorganisms are divided into seven types: bacteria, archaea, protozoa, algae, fungi, viruses, and multicellular animal parasites (helminthes). Each type has a characteristic cellular composition, shape, movement and reproduction. Microorganisms are beneficial in producing oxygen, decomposing organic material, providing nutrients for plants, and maintaining human health, but some can be pathogenic and cause diseases in humans. Evidently, presence of numerous risk factors listed in the figure predispose patients with chronic kidney disease and end stage kidney disease to microbial infections.


The microbial infections which may occur in patients with kidney diseases include septicemia, chronic meningococcemia, renal abscess, shunt infection, Brazilian purpuric fever, leptospirosis, Weil's disease, pneumonia, diarrhea, cholera, enteritis, tuberculosis, Rocky mountain spotted fever, Q fever, etc. The microorganisms causing these infections include Neisseria meningitides, Staphylococcus aureus, Staphylococcus epidermidis, Group A Streptococcus, Haemophilus influenza, Leptospira interrogans, Streptococcus pneumonia, Escherichia coli, Shigella, Salmonella species, Vibrio species, Klebsiella, Yersinia species, Campylobacter jejuni, Rickettsia rickettsia and Coxiella burnetii. Depending on the severity of the infection and the infecting microbe, the involvement of kidney may vary from insignificant proteinuria (presence of proteins in urine) to acute kidney failure (condition wherein kidney failure occurs rapidly within few hours or days) requiring dialysis (the process of clinical purification of blood as a substitute for the normal function of the kidney). The organisms causing acute kidney failure due to systemic sepsis (a life-threatening condition involving body’s immune response to the infection causing inflammation and organ failures) vary with age and geographic location and also differ in normal and immunocompromised individuals. Early detection and aggressive treatment of infections with effective antimicrobial agents may limit the degree of kidney injury. Of note, the nephrotoxic effects of antimicrobial agents used for the treatment of infection cannot be undermined which may be either sole reason or, contributory factor to kidney injury in many conditions. However, the time of recovery may vary from several days to weeks depending on the risk factors associated with the patient under treatment. Proper referral and follow-up are necessary to identify those with higher risk of progressive kidney disease.


References:

1) https://www.ncbi.nlm.nih.gov/books/NBK279387/

2) https://bio.libretexts.org/Bookshelves/Microbiology/

3) Dalrymple, L. S., & Go, A. S. (2008). Epidemiology of acute infections among patients with chronic kidney disease. Clinical Journal of the American Society of Nephrology, 3(5), 1487-1493.

4) Herberg, J., Pahari, A., Walters, S., & Levin, M. (2009). Infectious diseases and the kidney. Pediatric Nephrology, 1235.

5) Prasad, N., & Patel, M. R. (2018). Infection-induced kidney diseases. Frontiers in Medicine, 5, 327.

6) https://health.economictimes.indiatimes.com/ (Kidney Image)

About the author:

Aditya is current pursuing PhD in Biotechnology at Institute of Chemical Technology, Matunga, Mumbai. He holds an undergraduate degree in Microbiology from Ruia College, Mumbai and Master’s in Biophysics from University of Mumbai. He takes an avid interest in studying the concepts of protein biology from physics and chemistry point of view. Apart from an active involvement in scientific research, he likes photography, classical music and also participates in the activities of social interest.

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