For diagnosis and treatment of leishmaniasis, see Ch. Malaria causes various renal disorders. Transient glomerular lesions, mild proteinuria, and microscopic hematuria may be found, but hypertension and edema are usually absent. Histologic lesions resemble those in other immune complex diseases. In adolescents and adults, renal failure with the nephrotic syndrome is common.
Histologic findings are typical of immune complex glomerulonephritis.
Spontaneous remission of established quartan malarial nephrotic syndrome is very rare. Renal failure is progressive and leads to end-stage disease in about 3 to 5 yr. Antimalarial or corticosteroid therapy induces a remission or slows progression of renal failure only in patients with mild glomerulopathy. Schistosomiasis causes urinary lesions involving the bladder, lower ureters, and seminal vesicles and frequently the vas deferens, prostate, vagina, and adnexa. Symptoms are frequent micturition and, occasionally, dysuria.