Lyme Disease Associated With Kidney Problems
Kidney complications from Lyme disease are uncommon in humans but have been described in several published case reports.
These cases suggest that Borrelia burgdorferi infection may trigger immune-mediated kidney inflammation in susceptible individuals.
Two published cases highlight how Lyme disease-associated kidney problems may present with nephritis, hematuria, or glomerular injury. [1]
Case #1: Lyme Disease and Glomerulonephritis
A 57-year-old woman presented to the hospital with shortness of breath. Two weeks earlier, she experienced nausea, fatigue, headache, and myalgias before developing dyspnea with moderate exertion. She also reportedly had a rash on her shoulder. [1]
She was diagnosed with Lyme disease and initially treated with doxycycline. Concerned about possible disseminated Lyme disease, physicians later switched her to intravenous ceftriaxone.
Kidney biopsy findings included:
- Global hypercellularity
- Mesangial expansion
- Subendothelial deposits
The findings were described as consistent with immune complex-mediated membranoproliferative glomerulonephritis. [1]
The patient improved following treatment with steroids and antibiotics.
The authors suggested that “the temporal relationship, multisystem presentation, characteristic histology and response to antibiotics and steroids are consistent with a B. burgdorferi-induced, immune complex-mediated glomerulopathy.” [1]
Case #2: Lyme Disease and Hematuria
A 40-year-old Massachusetts man presented to the emergency department with gross hematuria (blood in the urine). One week earlier, he had sustained a tick bite and subsequently developed myalgias, sore throat, headache, and fever. [1]
Urine studies revealed dysmorphic red blood cells and red cell casts.
A renal biopsy demonstrated:
- Focal proliferation
- One cellular crescent
- Mesangial IgA reactivity
The findings were consistent with IgA nephropathy. [1]
The temporal relationship to Lyme infection raised the possibility that the infection triggered activation of a previously quiescent glomerular condition.
The patient began treatment with high-dose oral steroids.
During treatment, he developed a macular rash in the armpit region.
Testing for Lyme disease was positive, and he was subsequently treated with oral doxycycline.
How Lyme Disease May Affect the Kidneys
The authors proposed that immune activation associated with Lyme disease may contribute to kidney inflammation in certain patients. [1]
Rather than direct bacterial invasion alone, the kidney injury may involve immune complex deposition and inflammatory activation.
This pattern resembles other immune-mediated complications sometimes reported in disseminated Lyme disease.
Why These Cases Matter
Kidney complications associated with Lyme disease remain rare, but these reports highlight the importance of considering Lyme disease in patients from endemic regions who develop unexplained nephritis or hematuria.
Lyme disease-associated glomerular disease should be considered in patients from endemic areas presenting with nephritis. [1]
Learn more about disseminated Lyme disease and Lyme disease symptoms.
Frequently Asked Questions
Can Lyme disease affect the kidneys?
Rare kidney complications associated with Lyme disease have been described in medical case reports, including glomerulonephritis and nephritis.
What kidney symptoms have been linked to Lyme disease?
Reported symptoms include hematuria (blood in the urine), nephritis, proteinuria, and kidney inflammation.
How might Lyme disease cause kidney problems?
Researchers believe immune-mediated inflammation and immune complex deposition may contribute to kidney injury in some patients.
Are kidney complications from Lyme disease common?
No. Kidney involvement appears to be uncommon in humans but has been documented in published reports.
Can Lyme disease trigger existing kidney disease?
Some authors have suggested that Lyme disease-related immune activation may trigger flare-ups of previously quiet glomerular conditions.
Clinical Takeaway
Lyme disease-associated kidney problems appear to be rare but potentially serious.
These published cases suggest that immune-mediated inflammation triggered by Borrelia burgdorferi infection may contribute to glomerular injury in susceptible individuals.
Clinicians should consider Lyme disease in patients from endemic regions presenting with unexplained nephritis or hematuria.
Related Articles
Podcast: Kidney Failure Associated With Lyme Disease
Doctors Recognize Lyme Disease in a Patient With Kidney Disease
Neurologic Lyme Disease
Lyme Coinfections
Lyme Disease Misdiagnosis
References
- Mc Causland FR, Niedermaier S, Bijol V, Rennke HG, Choi ME, Forman JP. Lyme disease-associated glomerulonephritis. Nephrol Dial Transplant. 2011;26(9):3054-3056.
Dr. Daniel Cameron, MD, MPH
Lyme disease clinician with over 30 years of experience and past president of ILADS.
Symptoms • Testing • Coinfections • Recovery • Pediatric • Prevention
