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

Abstract

Chikungunya virus was detected in cases of acutechikungunya 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. 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. In the first group, 15 patients had kidney injury 0.5-24months 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 35.6months. Mean creatinine and proteinuria were 0.9mg/dl and 71.5mg/day, respectively. One patient had isolated hematuria. There was no indication for renal biopsy in this group. Several histopathological features were found after chikungunya fever, without virus detection in renal tissue. These findings suggestthat chikungunya virus may trigger kidneylesions with varying degrees of severity at different stages of infection. However, the probability thatthis virus replicates in therenal tissue seems unlikely.