PR002602 (Project)

Description:Strongyloides stercoralis exacerbates chronic kidney disease (CKD) through the disruption of metabolic processes. However, the metabolic consequences of infection and of its resolution after treatment remain poorly characterized. We investigated urinary metabolites before and after treatment of S. stercoralis-infected CKD patients. Fifteen patients with concurrent CKD and confirmed strongyloidiasis were assessed at baseline and 17 months post-antiparasitic treatment. We evaluated kidney function through standard biochemical markers (serum and urine creatinine, eGFR, microalbumin, and urinary albumin-to-creatinine ratio) and profiled the urinary metabolomics using untargeted LC/Q-TOF MS in positive and negative ionization modes. Multivariate, univariate, and pathway-enrichment analyses identified treatment-responsive metabolites, which were correlated with renal function markers. Treatment significantly improved fasting blood sugar and kidney function. Metabolomics revealed 91 significantly altered metabolites, mostly decreasing after therapy, suggesting reduced metabolic stress. Key treatment-responsive metabolites included sedoheptulose-7-phosphate, ascorbic acid, carbendazim, gluconic acid-γ-lactone, and 1-O-galloyl-6-O-cinnamoylglucose. Pathway analysis indicated disturbances in carbohydrate, amino acid, and redox metabolism—particularly glycine/serine and starch/sucrose pathways—that partially normalized post-treatment. The results demonstrate that antiparasitic therapy improves renal function and metabolic profiles in CKD patients, with specific metabolites identified as potential biomarkers for monitoring recovery. Our findings highlight the need for routine screening and timely treatment in CKD patients.