Bilharziasis and the kidney

Abstract

The association between schistosomiasis and disease of the kidneys is known to have existed for over 3,000 years because in 1911 Ruffer, examining the kidneys of Egyptian mummies of about 1,500 years before Christ, was able to demonstrate the presence of ova of S. haematobium. Unfortunately, the embalmers’ methods precluded examination of the lower urinary tract, but we know from writings on papyri of the same period that haematuria was a common symptom among the ancient Egyptians. Since the work of Bilharz in 1851, who demonstrated the organism responsible for the first time, it has been recognised that the association between schistosomiasis and renal disease is an indirect one and that direct invasion of the renal parenchyma by the parasite is uncommon. The renal disease arises by the effects of back pressure of urine due to damage of the lower ends of the ureters (fig. 1). In general, schistosomiasis appears to be a self-limiting disease and the majority of sufferers do not develop renal effects and recover spontaneously provided the lower ends of the ureters are not seriously involved.