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. 2022 Jul 1;23(7):2397-2405.
doi: 10.31557/APJCP.2022.23.7.2397.

Association between the Number of Repeated Praziquantel Treatments and Kidney Parenchymal Change in Northeast Thailand

Panuwat Prathumkam  1   2   3 , Kavin Thinkhamrop  3   4   5 , Narong Khuntikeo  2   4   6 , Nittaya Chamadol  2   4   7 , Jaruwan Thuanman  2   3 , Matthew Kelly  8 , Bandit Thinkhamrop  2   3   9
Affiliations

Association between the Number of Repeated Praziquantel Treatments and Kidney Parenchymal Change in Northeast Thailand

Panuwat Prathumkam et al. Asian Pac J Cancer Prev. .

Abstract

Background: In Northeast Thailand, Praziquantel (PZQ) is used to treat infection with the Opisthorchis viverrnini (OV). OV has highly prevalence in this area due to the traditional consumption of uncooked cyprinid fish. The nephrotoxic effects of PZQ metabolite excretion through the kidney have not been assessed yet. This study investigated the relationship between number of Praziquantel treatments and kidney parenchymal change.

Methods: A study was carried out on participants from the Cholangiocarcinoma Screening and Care Program (CASCAP) between 2013 - 2018. The frequency of PZQ use was reported using a standardized questionnaire. Kidney parenchymal change (KPC) was defined as having a kidney abnormality based on ultrasonography diagnosed by well-trained general practitioners. Adjusted odds ratios (ORs) measured associations between PZQ frequency and KPC controlling for the effects of other extraneous factors using multiple logistic regression.

Results: A total of 490,969 subjects with mean age of 55.2 (SD = 9.15) years were enrolled among them 62.1% were female. Prevalence of KPC was 1.2% while prevalence of KPC were 1.2%, 1.3%, 1.4%, and 1.5% for participants with one, two, three, and more than 3 PZQ treatment occasions respectively. Those dose-response relationship was statistically significant based on chi-square test for trend (p-value <0.001). After controlling for possible confounders, compared to non-treatment, subjects with more than 3 treatment occasions were 25% more likely to have a KPC positive result (OR = 1.25; 95% CI: 1.02 - 1.52; p-value = 0.028).

Conclusion: The number of repeated PZQ treatments is statistically significantly related to KPC. This relationship could be included in health messaging for those who continue eating uncooked fish with an understanding that the OV infection can easily be cured by PZQ without any other health concerns. For positive OV cases, however, the known efficacy of PZQ could over-ride the small magnitude of the adverse effect.

Keywords: Screening; Ultrasonography; kidney parenchymal change; praziquantel treatment.

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Figures

Figure 1
Figure 1
Ultrasound Images of Kidney Parenchymal Change. (A), Left kidney parenchymal change; (B), Right kidney parenchymal change
Figure 2
Figure 2
Sample Selection Process
Figure 3
Figure 3
Percentage of Positive Kidney Parenchymal Change by Sex According to Number of Praziquantel Treatments
Figure 4
Figure 4
Number of Cases Positive for Kidney Parenchymal Change by Frequency of Praziquantel Treatments and Age
Figure 5
Figure 5
Forest Plot of Crude Odds Ratio and Odds Ratio adjusted for gender, age, education, occupation, smoking, drinking alcohol, diabetes mellitus, and hypertension measuring associations between repeated praziquantel treatments and kidney parenchymal change
See this image and copyright information in PMC

References

    1. Abd ElHafeez S, Hegazy R, Naga Y, et al. Non-steroidal anti-inflammatory drugs among chronic kidney disease patients: an epidemiological study. J Egypt Public Health Assoc. 2019;94:8. - PMC - PubMed
    1. Bailey RA, Wang Y, Zhu V, et al. Chronic kidney disease in US adults with type 2 diabetes: an updated national estimate of prevalence based on Kidney Disease: Improving Global Outcomes (KDIGO) staging. BMC Res Notes. 2014;7:415. - PMC - PubMed
    1. Bhamarapravati N, Thammavit W, Vajrasthira S. Liver changes in hamsters infected with a liver fluke of man, Opisthorchis viverrini. Am J Trop Med Hyg. 1978;27:787–94. - PubMed
    1. Brennan A, Evans D, Maskew M, et al. Relationship between renal dysfunction, nephrotoxicity and death among HIV adults on tenofovir. AIDS. 2011;25:1603–9. - PMC - PubMed
    1. Cha’on U, Wongtrangan K, Thinkhamrop B, et al. CKDNET, a quality improvement project for prevention and reduction of chronic kidney disease in the Northeast Thailand. BMC Public Health. 2020;20:1299. - PMC - PubMed