Clearance of Strongyloides stercoralis infection using ivermectin improves kidney function and modulates untargeted urinary metabolomic profile in patients with early-stage chronic kidney disease
8 affiliations
- 1Biomedical Sciences Program, Graduate School, Khon Kaen University, Khon Kaen, Thailand
- 2Chronic Kidney Disease Prevention in Northeastern Thailand, Khon Kaen University, Khon Kaen, Thailand
- 3Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
- 4Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- 5Centre for Research and Development of Medical Diagnostic Laboratories, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
- 6Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- 7Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- 8College of Science and Engineering, James Cook University of North Queensland, Townsville, Australia
Abstract
Introduction: Strongyloides stercoralis exacerbates the early stages of 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. This study explores urinary metabolic changes in patients with early-stage CKD following antiparasitic therapy.
Methods: In an exploratory before-and-after longitudinal study design, fifteen patients presenting with concurrent early-stage CKD (stages 1–3) and confirmed strongyloidiasis were monitored at baseline and 17 months following ivermectin anthelmintic treatment. Serum and urine clinical biochemistry assessments were paired with high-resolution untargeted liquid chromatography-quadrupole time-of-flight mass spectrometry (LC/Q-TOF MS) urinary metabolomic profiling executed in both negative and positive ionization modes.
Results: Global multivariate analyses did not demonstrate statistically significant separation between pre- and post-treatment urinary metabolomic profiles. However, univariate analyses identified 91 significantly altered urinary mass features following treatment. Among these, thirteen metabolites (twelve decreased and one increased) were identified as potential markers associated with parasite clearance in patients with CKD. Changes in fasting blood sugar, serum creatinine, and estimated glomerular filtration rate (eGFR) were also observed. Notably, urinary 1-O-galloyl-6-O-cinnamoylglucose was negatively correlated with urine creatinine, while sedoheptulose-7-phosphate levels was negatively correlated with serum creatinine. Additionally, urinary ascorbic acid levels increased following treatment, suggesting their potential relevance to kidney function. Pathway analysis indicated disturbances in amino acid and carbohydrate metabolism, particularly glycine/serine metabolism, tyrosine metabolism, and glycolysis, that partially normalized post-treatment.
Conclusion: These findings suggest that clearance of S. stercoralis infection was associated with changes in urinary metabolomic profiles in patients with CKD. Kidney function and urinary metabolomic profiles were observed in patients with early-stage CKD and S. stercoralis infection. Further investigations of kidney outcomes following S. stercoralis clearance and of the potential value of strongyloidiasis screening in patients with CKD are warranted.
Related
- The Strongyloides stercoralis nervous system
- Prevalence of Strongyloides stercoralis infection among African children: A systematic review and meta-analysis
- Tracing Strongyloides stercoralis transmission and risk factors from schoolchildren to household in Northwest Ethiopia
- Shotgun metagenomic and untargeted metabolomic analysis of gut microbiome associated with peripheral artery disease
- Untargeted Metabolomics Reveals Regional and Cultivar-Associated Metabolomic Variation in Soybeans Across Northeast China
BibTeX
@article{tunbenjasiri2026clearance,
title = {{Clearance of Strongyloides stercoralis infection using ivermectin improves kidney function and modulates untargeted urinary metabolomic profile in patients with early-stage chronic kidney disease}},
author = {Keerapach Tunbenjasiri and Suppakrit Kongsintaweesuk and Kornpatchara Chaiyachate and Aye Myat Mon and Thatsanapong Pongking and Apinya Jusakul and Sirirat Anutrakulchai and Apisit Chaidee and Porntip Pinlaor and Nuttanan Hongsrichan and Ubon Cha’on and David Blair and Somchai Pinlaor},
journal = {PeerJ},
year = {2026},
month = oct,
doi = {10.7717/peerj.21832},
url = {https://peerj.com/articles/21832},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Clearance of Strongyloides stercoralis infection using ivermectin improves kidney function and modulates untargeted urinary metabolomic profile in patients with early-stage chronic kidney disease
AU - Keerapach Tunbenjasiri
AU - Suppakrit Kongsintaweesuk
AU - Kornpatchara Chaiyachate
AU - Aye Myat Mon
AU - Thatsanapong Pongking
AU - Apinya Jusakul
AU - Sirirat Anutrakulchai
AU - Apisit Chaidee
AU - Porntip Pinlaor
AU - Nuttanan Hongsrichan
AU - Ubon Cha’on
AU - David Blair
AU - Somchai Pinlaor
PY - 2026
DA - 2026/10/29
JO - PeerJ
DO - 10.7717/peerj.21832
UR - https://peerj.com/articles/21832
AB - Introduction: Strongyloides stercoralis exacerbates the early stages of 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. This study explores urinary metabolic changes in patients with early-stage CKD following antiparasitic therapy. Methods: In an exploratory before-and-after longitudinal study design, fifteen patients presenting with concurrent early-stage CKD (stages 1–3) and confirmed strongyloidiasis were monitored at baseline and 17 months following ivermectin anthelmintic treatment. Serum and urine clinical biochemistry assessments were paired with high-resolution untargeted liquid chromatography-quadrupole time-of-flight mass spectrometry (LC/Q-TOF MS) urinary metabolomic profiling executed in both negative and positive ionization modes. Results: Global multivariate analyses did not demonstrate statistically significant separation between pre- and post-treatment urinary metabolomic profiles. However, univariate analyses identified 91 significantly altered urinary mass features following treatment. Among these, thirteen metabolites (twelve decreased and one increased) were identified as potential markers associated with parasite clearance in patients with CKD. Changes in fasting blood sugar, serum creatinine, and estimated glomerular filtration rate (eGFR) were also observed. Notably, urinary 1-O-galloyl-6-O-cinnamoylglucose was negatively correlated with urine creatinine, while sedoheptulose-7-phosphate levels was negatively correlated with serum creatinine. Additionally, urinary ascorbic acid levels increased following treatment, suggesting their potential relevance to kidney function. Pathway analysis indicated disturbances in amino acid and carbohydrate metabolism, particularly glycine/serine metabolism, tyrosine metabolism, and glycolysis, that partially normalized post-treatment. Conclusion: These findings suggest that clearance of S. stercoralis infection was associated with changes in urinary metabolomic profiles in patients with CKD. Kidney function and urinary metabolomic profiles were observed in patients with early-stage CKD and S. stercoralis infection. Further investigations of kidney outcomes following S. stercoralis clearance and of the potential value of strongyloidiasis screening in patients with CKD are warranted.
SN - 2167-8359
ER -