6Renal Involvement in Tropical Diseases

Tropical nephrology is no longer a regional issue. With the enor-mous expansion of travel and immigration, the world has becomea global village. Today, a health problem in a particular region has worldwide repercussions. Typical examples are the acquisition of malaria in European airports, renal disease associated with herbal medications, and increasing encounters of parasitic infections in immunocompromised persons [1–3]. Lessons learned from the study of tropical diseases have considerably enriched worldwide medical knowledge of the basic and clinical aspects of nontropical diseases. Examples include better understanding of macrophage function in vitro, the role of cytokines in acute renal failure, and the importance of immunoglobulin A deposits in the progression of glomerular disease [4–7]. The so-called typical tropical nephropathies are broadly classified as infective or toxic. Infective nephropathies include renal diseases associat-ed with endemic bacterial, viral, fungal, and parasitic infections. Toxic tropical nephropathies include exposure to poisons of animal origin, such as snake bites, scorpion stings, and intake of raw carp bile, and plant ori-gin, such as certain mushrooms and the djenkol bean [3]. Tropical bacterial infections often are associated with renal complica-tions that vary according to the causative organism, severity of infection, and individual susceptibility. The principal acute infections reported to affect the kidneys are salmonellosis, shigellosis, leptospirosis, melioidosis, cholera, tetanus, scrub typhus, and diphtheria [8–16]. Renal involvement in mycobacterial infections such as tuberculosis and leprosy usually pur-sues a subacute or chronic course [17–19]