If you ever had a parasitic infection, you must be aware of the Ivermectin drug. And if you are taking or have taken Ivermectin treatment, like many other drugs you must be doubtful about kidney damage. Certain medications may damage your kidneys if you use these drugs for longer periods. In this blog, we are going to talk about does Ivermectin affect your kidneys or not.
What is Ivermectin Treatment?
Ivermectin is a generic prescription medication expansively used to treat various kinds of parasitic infections in adults and kids. Most commonly Ivermectin is prescribed for treating strongyloidiasis and onchocerciasis (river blindness). Ivermectin treatment is prescribed as a short-term treatment and it is rarely prescribed for long term in certain cases.
Ivermectin drug is available in the form of an oral tablet that you need to swallow with water. Ivermectin cream and Ivermectin lotion are also available which you need to apply on your skin. Ivermectin lotion and cream are for external use only so do not take them by mouth.
Ivermectin Treatment for Covid 19
World Health Organization (WHO) and Food and Drug Administration (FDA)have discouraged the use of Ivermectin for the treatment of coronavirus disease. FDA chief stated that Ivermectin distribution for humans is only legal when prescribed by a doctor and compounded by a genuine licensed pharmacy.
The Infectious Diseases Society of America’s Covid 10 guidelines panel warn people against the use of Ivermectin treatment outside the context of a clinical trial in outpatients.
The Efficiency of Ivermectin Treatment
The genius drug Ivermectin has shown several potential effects to treat and prevent a broad range of diseases due to its antiviral, antimicrobial and anti-cancer properties. Ivermectin is extremely effective against various microorganisms including certain viruses, therefore it was considered a prospective drug for the treatment of an assortment of viruses including Covid 19 along with many other types of single-stranded RNA viruses.
Ivermectin restricts the nerve and muscle function of insects and helminths by sticking to their glutamate-gated chloride channels lashing them to pen, growing chloride ions flow, hyperpolarizing the cell membranes, incapacitating the affected tissue, and killing them. In mammals including humans, these channels exist only in the spinal cord and brain and are not affected by Ivermectin as it is unable to cross the blood-brain barrier.
Other than having antiparasitic and antiviral effects, Ivermectin initiates immunomodulation in the hots, impeding the production of cancer cells and controlling cholesterol and glucose. Some of these effects caused by Ivermectin may be secondary to toxic effects on the cells.
Recent studies have shown that Ivermectin possesses antiviral action against the SARS-CoV-2 clinical isolate in vitro. A single dose of Ivermectin is efficient to control viral replication within 24 to 48 hours in our system. It is probably through constraining IMPα/β1-mediated nuclear ingress of viral proteins for other RNA viruses.
In the case of SARS-CoV-2, if Ivermectin is given to patients during early infection, it can help limit viral load, avert severe disease progression and avoid person-to-person transmission. Moreover, it is reported that Ivermectin is recommended to be a hopeful, safe and effective chemoprophylactic medication in Covid 19 management.
Is Ivermectin Associated With Kidney or Cardiac Side Effects?
Some are excreted unaltered by the kidneys or their metabolites and may enhance the risk of toxicity and adverse reactions in patients with abnormal kidney function. Ivermectin is not known to cause kidney-related side effects. It may cause some cardiac or heart-related side effects such as increased heart rate or low blood sugar. However, Ivermectin is not known to cause any serious cardiac-related issues.
Parasitic infections that require Ivermectin treatment can lead to kidney or heart problems or may impact normal kidney function. In case you experience any symptoms of kidney problems including fatigue, how often you urinate, vomiting or nausea talk to your doctor as soon as possible. Also if you notice any symptoms of cardiac problems such as chest pain, dizziness or difficulty breathing contact your doctor or healthcare provider immediately.
What is Chronic Kidney Disease and Acute Kidney Injury?
Chronic kidney disease is a health condition in which the kidneys are injured and cannot filter the blood as well as they are supposed to. Because of this condition, excess waste and fluid excluded from the blood stays in the body and may lead to other health issues such as stroke and heart disease.
Chronic kidney disease is also known as chronic kidney failure and it involves steady loss of kidney function. Kidneys filter the excess fluids and waste from your blood and remove them through the urine. Progressive chronic kidney disease can lead to dangerous levels of fluid, wastes and electrolytes build up in the body.
On the other hand, an acute kidney injury is when your kidneys stop working properly suddenly. It can vary from a slight loss of kidney function to complete kidney failure. Usually, it happens as a snag of other serious illnesses and it does not occur as a result of a physical blow to the kidneys.
Who is At Risk for Developing Chronic Kidney Diseases?
Well, anybody can get chronic kidney disease. However, you are highly at risk of developing chronic kidney disease if you have diabetes, high blood pressure, heart disease, a family history of kidney disease, abnormal kidney size or structure, you are over 60 years of age or if you have a long history of taking Nonsteroidal Anti-Inflammatory Drugs (NSAID) pain relievers. It includes some prescription pain relievers and over-the-counter products.
Chronic Kidney Disease And Medications To Be Mindful With
Many prescription and non-prescription medications may weaken kidney function and cause kidney damage. If you are diagnosed with chronic kidney disease, your doctor may suggest you continue to take such medications but may alter how much you can take or may change your medicine. Make sure you consult your doctor before starting or stopping any medicine.
Medications that may need to be adjusted, changed or avoided as these can put you at risk of chronic kidney diseases include:
- Nonsteroidal anti-inflammatory drugs such as naproxen and ibuprofen.
- Aspirin and acetaminophen can be harmful when used for extended periods.
- Herbal supplements contain minerals such as potassium that are destructive for people with kidney disease. Many herbs may interact with certain prescription medicines.
- Statin medications such as simvastatin and lovastatin.
- Diabetes medicines such as metformin and insulin.
- Upset stomach and heartburn medicines such as Alka-Seltzer and Milk of Magnesia.
- Antimicrobial drugs include some antiviral, antifungal and antibiotics medications.
Ivermectin During Pregnancy Or Breastfeeding
The safety of Ivermectin during pregnancy is not known. If you are pregnant or trying to conceive, make sure you talk to your doctor before taking Ivermectin. They may adjust your dose accordingly or may suggest an alternative treatment option for your condition.
Ivermectin can pass into breast milk and possibly cause side effects in the nursing baby. Tell your doctor if you are breastfeeding your baby so that they can determine whether Ivermectin is safe for you and your baby or not.
Ivermectin and Alcohol
The interactions between alcohol and Ivermectin are not known. However, drinking alcohol while taking Ivermectin tablets may increase the risk of side effects such as dizziness, nausea or vomiting and sleepiness. If you regularly consume alcohol, make sure you ask your doctor before starting your treatment.
Ivermectin Cautions
Ivermectin may not be the right treatment for people with certain medical conditions. These are called drug-condition interactions as Ivermectin and certain other drugs may lead to drug interactions. Tell your doctor about your complete health history before starting with Ivermectin treatment.
Immune system conditions
Ivermectin may not work well as it is supposed to in people suffering from immune system conditions. Tell your doctor or healthcare provider about the health condition you have that can affect your immune system such as HIV.
Allergic reaction
If you ever had an allergic reaction to Ivermectin or other ingredients of this drug, you should not take this medicine. Your doctor may recommend other options for you.
Liver problems
These are not common at all, but in rare cases, Ivermectin may cause liver damage. If you already have liver conditions, taking Ivermectin may worsen the problems.
Can Ivermectin Harm Kidney Function or Other Organs?
With the growing demand to fight Covid 19, it is extremely important to examine the toxic effect of Ivermectin on several body organs. When a person takes Ivermectin, it enters the body orally and reaches the blood and body organs such as the kidney and liver for metabolism.
Moreover, the antiparasitic drug Ivermectin has enthused oxidative stress in North African Catfiush tissue. The common adverse effects of Ivermectin stated by clinical trials are headache, muscle pain, nausea, diarrhoea, vomiting, confusion, pruritus and hypotension etc.
Several studies demonstrated that antioxidative substances protect cells against the damaging effects of various environmental agents. Antioxidants may preserve cell membrane function and flexibility. Ascorbic acid vitamin C is an essential adjunctive therapy for sepsis, respiratory function and Covid 19.
Due to the extremely increasing consumption of vitamin C and ivermectin in the hope to treat covid 19, numerous questions are emerging about the safety of its use in infected children because of nephrotoxic effects of Ivermectin have been completely clarified in juvenile age.
Homogenate Kidney Tissue Analysis for Oxidant/Antioxidant Activities
Measuring TAC and the activities of antioxidant enzymes SOD, CAT and GPx in kidney tissues of various study subgroups in adult and juvenile rats demonstrated that the administration of Vitamin C results in increased TAC and antioxidant enzyme activities. On the other hand, rats administered with Ivermectin showed an extremely significant reduction in activities of TAC, SOD, CAT and GPx with a considerable increase in ROS.
Though consumption of Vitamin C equivalent to Ivermectin in both Vitamin C and Ivermectin subgroups showed stability of oxidant/antioxidant activities near the control group. Comparing both adult and juvenile groups presented that young rats had more falloff in oxidants activity in the treated group and less threatened consequence of Vitamin C.
Real-time quantitative reverse-transcription polymerase chain reaction for MMP-9
PCR examination of samples attained from various study subgroups had influentially shown that matrix metalloproteinase 9 (MMP9) was statistically significant in Ivermectin-treated subgroups in comparison to control which indicates basement membrane deprivation as MMP9 has been viewed among the key enzymes accountable for basement membrane ruin.
Although consumption of vitamin C similar to Ivermectin displayed partial stability against this degradation. Comparing adult and juvenile groups revealed that adult rats had higher levels of MMP9 in all subgroups.
H&E Histopathological and Morphometric Results
H&E marked sections of control and vitamin C subgroups in both adult and juvenile rats demonstrated nearly the same outcomes with normal renal histology. Corpuscles are shaped of a dense rounded glomerulus encircled by a parietal layer of Bowman’s capsule and renal tubules with the urinary space in-between. Additionally, proximal convoluted tubules were creased with low columnar cells with spherical basal nuclei and distal convoluted tubules were creased with low cuboidal cells with round central nuclei.
Conclusion
Serum markers analysis outcomes kidney function test demonstrated that rats treated with Ivermectin had an extremely significant rise in the kidney function marker SCr, BUN as compared to control and Vitamin C subgroups.
Ivermectin administration led to a weakening in kidney function, a reduction in antioxidant enzyme activities and an increase in MMP9 activity, noteworthy histological and ultrastructural variations and an increase in the percentage of Bax proapoptotic protein expression.
All these variations were more understandable in the juvenile group whereas co-administration of vitamin C directed to eighty protection which was extreme in the adult group. So Ivermectin needs to be suggested and used cautiously, particularly in juvenile-age patients and co-administration of Vitamin C is vastly recommended.
Liver And Kidney Function Trends In A Population Under Mass Treatment With Ivermectin In Onchocerciasis Endemic Region (Cameroon)
In Cameroon, the transmission of onchocerciasis remains persistent despite the mass administration of Ivermectin for over 16 years. Thus community-directed treatment with Ivermectin endures. Long-term exposure to Ivermectin ensuing repeated annual distribution of Ivermectin to treat onchocerciasis in kidney and liver functions could lead to a gap in community-directed treatment with Ivermectin.
Inadequate data is available on kidney and liver function parameters following yearly Ivermectin treatment. Thus this study reports the kidney and liver functions of people who have been taking Ivermectin as compared to those not treated in the Menchum Valley of north West Cameroon.
Procedures
A community-based cross-sectional and analytical study was performed between 2018 to 2020. A multistage sampling technique was executed to pick thr participants. A semi-structured questionnaire was used to collect data on sociodemographic characteristics and Ivermectin treatment status from each participant and two skin snips from the iliac area for microscopic detection of O. volvulus.
Biochemical markers of the liver (alanine aminotransferase and Aspartate aminotransferase) and kidney (urea, creatinine, creatinine clearance) functions were examined on blood specimens collected from each participant. The urine sample was taken for proteinuria. Statically analyses were performed to compare the maens+/- SEM using SPPS 21.0.p was set at a weighty level less than 0.05.
Outcomes
1401 Menchum Valley residents of 15 years and above age were enrolled in this study including 249 males and 1152 females. The occurrence of onchocerciasis (river blindness) was 4.02 %. A high occurrence of abnormal liver function was observed in 782/1401 and 668/1401 for AST and ALT respectively. However, in uninfected participants, no statically significant association was recognized between those taking and not taking Ivermectin treatment.
The occurrence of abnormal kidney function revealed 161/1345, 227/1345 and 103/1345 for creatinine, urea and creatinine clearance respectively. A high level of creatinine and urea of uninfected people taking and not taking Ivermectin specified a significant association with Ivermectin uptake. Means +/- for proteinuria between uninfected and not on Ivermectin people was statically significant.
Analysis of kidney function test
The biochemical parameters counted consisted of serum urea, creatinine, urine creatinine, creatinine clearance and protein. Serum urea was determined by kinetic UV method urease-GLDH at 37 degree Celsius with 340 nm wavelength. The serum and urine creatinine were determined based on Jaffe-Reaction photometric colouration test at 37 degree Celsius with 510 nm wavelength. In the meantime, creatinine clearance was calculated based on the equation, Creatinine clearance = urine creatinine volume of urine/serum creatinine into 24 hours.
Normal values were determined as urea 14-45 mg/dl, serum creatinine 0.6-1.1 and 0.90-1.30 mg/dl for women and men respectively and creatinine clearance 70-140 ml/mins/1.73. Urine for 24 hours was collected from each participant in order to analyse if there is altered kidney function. Participants were advised to throw away the morning’s first urine and observe the time to collect urine for 24 hours.
The volume of collected urine was noted and urine samples were meticulously sharked for homogeneity and 3ml of urine was dispensed into suitably labelled test tubes to determine urine chemistry. It was diluted for urine creatinine at 1.100 and urine protein was measured using Mission series test strips. These strips were dipped into the urine for around 3 seconds and the colour changed to red by comparing to a standard provided by the manufactured and the results were recorded in g/l. Normal values of Proteinuria were less than 0.30 g/l.
Conclusion
From this study, mild kidney and liver injury was noticed. It may ascribe that Ivermectin seems to cause just minor damage to the glomerulus. Thus mass drug administration of Ivermectin could be continued to make sure onchocerciasis elimination.
The repeated use of Ivermectin is not associated with affected liver functions such as ALT and AST however induced considerable modifications in kidney functions such as urea levels and serum creatinine. Regular monitoring and evaluation of these organs should be done routinely.
Side Effects of Ivermectin
Ivermectin may cause side effects like any other drug and most of these are mild. Commonly reported side effects of Ivermectin include fatigue, stomach pain, diarrhoea, vomiting, nausea, sleepiness, constipation, headache, muscle pain, fever, joint pain, swelling in face or arms, skin rash, itching, mild allergic reaction and dizziness.
Mostly these side effects are temporary and can be managed easily. In case you experience ongoing symptoms that bother you call your doctor and seek medical help.
Although most Ivermectin side effects are mild, the improper use of medication or certain health conditions may increase the risk of serious side effects. These side effects include Neurological issues, serious eye problems, severe skin reactions, low blood pressure, increased heart rate, and liver damage.
If you experience any of these serious side effects talk to your doctor immediately. If these side effects appear life-threatening get urgent medical attention.
Wrapping words:
Talk to your doctor about possible side effects and adverse reactions before beginning with Ivermectin treatment. Tell them about any medications or herbal supplements you are taking so that they can adjust your medication accordingly. Keep track of the side effects if you experience any while taking Ivermectin. Get your kidney, liver and heart tested regularly.
Usually, Ivermectin is well tolerated by kidneys. The liver injury reported with Ivermectin use is mild and self-limited in courses. You can get your kidney function checked with a blood test for serum creatinine to evaluate whether your kidneys are filtering waste from the blood.
