Renal involvement in leprosy.
Renal involvement in 13 non-lepromatous and 17 lepromatous leprosy patients were assessed by routine urinalysis, detailed biochemical analysis of blood and urine and by renal histopathological studies and compared with 10 normal healthy controls. The presence of RBC and pus cells were detected in the urinary deposit of only one lepromatous leprosy patient in reactional phase. A reversal of albumin/globulin ratio was observed in 17.6% of non-lepromatous and 15.3% of lepromatous patients. 24 hours urinary excretion of sodium, potassium, chloride and aminonitrogen of the patients were within the normal range. Forth seven percent of the non-lepromatous and 46% of the lepromatous patients had proteinuria. Even though the mean serum creatinine values of the patients showed no difference from that of the normals, the creatinine clearance was low in 82.3% of the non-lepromatous and in all of the lepromatous patients. Serum phosphorus, serum uric acid, urinary phosphate excretion and the renal tubular reabsorption of phosphorus of the patients were normal. Twenty one percutaneous renal biopsy specimens showed nonspecific pathological changes such as nephritis of various varieties in 71.4% of the specimens. Among the lepromatous group renal involvement was observed in 5 out of 9 cases (55.6%) and in the non-lepromatous group 10 out of 12 cases (83.3%). No acid fast bacilli, amyloid and granuloma were seen in any of the renal tissues studied. There was no definite correlation between the type of renal pathology and biochemical changes. None of the patient showed any clinical evidence of renal involvement.