Covert or latent Toxoplasma gondii infection significantly correlated with CKD, reveals research

Covert or latent Toxoplasma gondii infection is significantly correlated with chronic kidney disease, according to research published in BMC Nephrology. Patients with chronic kidney disease are susceptible to acquiring opportunistic parasites due to acquired immunodeficiency caused by uremia.

Therefore, the present case–control study attempted to determine the prevalence of Toxoplasma gondii infection and the associated risk factors among patients with chronic kidney disease undergoing hemodialysis and healthy controls who were registered at the Iranian National Registry Center for Toxoplasmosis in Mazandaran Province, northern Iran.

A total of 212 patients with chronic kidney disease and 200 healthy controls were enrolled in this study. Informed consent and a questionnaire were obtained from all subjects. Blood samples were collected from each participant, and the serum was screened for anti-Toxoplasma antibodies (immunoglobulin G and immunoglobulin M). Polymerase chain reaction assay was performed to detect circulating Toxoplasma gondii in the blood samples of patients and controls using the primer pair targeting the repetitive element gene.

Results indicated that out of 412 participants, 67.92 percent of patients and 15.5 percent of control subjects were positive for anti-Toxoplasma immunoglobulin G, but all participants were negative for anti-Toxoplasma immunoglobulin M. Also, considering polymerase chain reaction assays with the repetitive element target, the prevalence of Toxoplasma gondii infection was 24.1 percent in case subjects, while none of the control subjects tested positive. Among the polymerase chain reaction-positive cases, 34 (66.7 percent) had Toxoplasma immunoglobulin G positivity.

The results from the multiple multinomial logistic regression revealed that the seroprevalence of anti-Toxoplasma gondii immunoglobulin G antibodies in patients with chronic kidney disease was 3.12 times higher than in healthy controls (odds ratio = 3.12; 95 percent confidence interval = 0.43, 14.8; P < 0.001). Also, there was a significant association between the seroprevalence of Toxoplasma gondii infection and age, having a cat at home, and the level of glomerular filtration rate in these patients. The findings demonstrate a highly significant association between latent Toxoplasma gondii infection and chronic kidney disease, mostly in the late stages. Thus, regular screening for Toxoplasma gondii infection in these patients is strongly recommended to prevent the reactivation of latent infections.

A combination of serological screening, chemoprophylaxis, and polymerase chain reaction follow-up for patients at risk of reactivation should effectively reduce the likelihood of latent infection reactivation.

Reference:

Montazeri, M., Fakhar, M., Sedighi, O. et al. Latent Toxoplasma gondii infection and associated risk factors among patients with chronic kidney disease: a registry-based study. BMC Nephrol 26, 163 (2025). https://doi.org/10.1186/s12882-025-04079-2