Doctors recognize Lyme disease in a patient with kidney disease

Kidney disease induced by Borrelia burgdorferi has been commonly reported in dogs but in the literature there are only a few cases of Lyme disease-associated renal damage in humans. In the February 2017 issue of BMC Nephrology, Florens and colleagues discuss the “unique case of minimal change disease (MCD) associated with chronic Lyme borreliosis that resolved completely after treatment with ceftriaxone and corticosteroids.” [1]

The article, “Chronic Lyme borreliosis associated with minimal change glomerular disease: a case report,” cites four published papers describing kidney damage in Lyme disease patients. The papers consisted of 4 cases of membranoproliferative glomerulonephritis (MPGN), a case of crescentic and IgA-deposit nephropathy, and a case of membranous nephropathy. [1]

In another case, the authors describe a 65-year-old Caucasian woman admitted for an acute edematous syndrome related to a nephrotic syndrome. She had a history of hypertension, dyslipidemia, and elevated blood pressure of 163/89 mmHg. Laboratory data showed hypoalbuminemia (1,2 g/dl), severe proteinuria (7,03 g/24 h) and a recent decrease of renal function (serum creatinine level increase from 0,84 to 1,3 mg/dl). Renal biopsy showed minimal change glomerular disease (MCD). [1]

Lyme disease was diagnosed based on positive serologic tests and a 2-year history of violaceous skin lesions of the right calf. The lesions were diagnosed as Acrodermatitis chronica atrophicans (ACA) by skin biopsy. ACA is a Lyme disease finding in Europe. The patient recalled a history of a tick bite on the same leg 9 years earlier without a rash or arthritis.

“This patient is the first case of minimal change glomerular disease associated with chronic Lyme borreliosis,” according to Florens from Edouard Herriot Hospital, Lyon, France. The patient’s nephrotic syndrome and MCD resolved with a combination of intravenous ceftriaxone and the steroid prednisolone.

The leg lesions and neuropathic pain, which persisted despite 21 days of ceftriaxone and prednisolone, cleared following a second course of 32 days of IV ceftriaxone therapy along with pregabalin.

Based on their investigations, Florens and colleagues recommend further studies of the association between kidney disease and Lyme disease. “The decrease of proteinuria after ceftriaxone therapy observed in our case suggests a link between MCD and Lyme disease,” according to Florens. “T-cells, podocytes and bacterial wall antigens could be involved.”

This case reminds doctors of the need to recognize Lyme disease in patients with kidney disease even if an association has not been established.



  1. Florens N, Lemoine S, Guebre-Egziabher F, Valour F, Kanitakis J, Rabeyrin M, Juillard L: Chronic Lyme borreliosis associated with minimal change glomerular disease: a case report. BMC Nephrol 2017, 18(1):51.

39 Replies to "Doctors recognize Lyme disease in a patient with kidney disease"

    03/25/2020 (11:48 am)

    My husband and I both have Lyme and stage 2 kidney disease. We are healthy otherwise. Our primary doctor states this is just a coincidence. Do you have information available I can use to help convience him to investigate further?

    • Dr. Daniel Cameron
      03/25/2020 (6:29 pm)

      I have not seen kidney disease in my Lyme disease. I am not a nephrologist. It could be a coincidence.

    • Dianne Stewart
      09/25/2022 (10:47 am)

      My husband and I both have Lyme and both have kidney/bladder problems. We get no sleep as up for bathroom every hour and a half. Urinalysis etc show nothing and doctors just have blank looks. Please let me know if you have had any luck with this problem. Our Lyme doc retired couple years ago and we have been taking Dr. Rawls supplements for 2 years. Only problem we have is this kidney or bladder issue. But seems to be getting worse.

  • Debbie
    01/16/2020 (7:57 am)

    I was interested in this article, since being diagnosed with Anaplasma (a tick borne disease) and then after months of more and more symptoms finally diagnosed with Lyme. Since then I have ended up in Urgent care with unexplainable pain, fatigue and high fevers that come and go. Each time with a question to me do you have pain when your urinate or increased frequency. I had neither each time. However, my urine has had trace of blood and indicates infections. My physical symptoms besides the above mentioned have also been extremely painful lower to mid back and my lower ribs feel like they are being squeezed in a vice. They hurt so bad that I can barely breath when I take a deep breath. From what I was told the pain from my kidneys is radiating and causing this discomfort.
    The fatigue is so bad I can fall asleep have a conversation. Yet, my doctors refuse to connect any of this to Chronic Lyme’s. This past year since being diagnosed in June of 2019. I will be on close to 110 days of antibiotics and still having issues! On top of this I have Guillane Barre Syndrome. So when my system is complicated I have flare ups with my neurological system. Thank you for this study it helps me to take better control of my health. Now to get the doctors to listen!!

    • Nancy
      06/09/2020 (10:48 am)

      How is your Lyme journey going? My kids and I also have Lyme.

  • Joan OBrien-Singer
    10/20/2018 (9:12 pm)

    Hello Dr.Cameron

    I now have cystic kidney disease. The first cysts were discovered when I received my first round of IV rocephin many many years ago. My urologist wasn’t concerned about them and my radiologist followed them annually. I still have some Lyme symptoms from time to time however my LLMD in Florida retired so I haven’t had treatment for chronic Lyme for a long time. My thought is that if there is a connection of kidney disease and Lyme in dogs, it makes sense to me since we are both mammals that there must be a connection. I wonder why insufficient research in humans has been underway. I have an appointment with a nephrologist the end of November (first available appointment) and I imagine he will pooh pooh this possibility. I miss NewYork dreadfully if you catch my drift. Warm regards , Joan O’Brien -Singer.

    • Dr. Daniel Cameron
      10/21/2018 (12:53 pm)

      It have also had a interest in the renal failure seen in dogs. I have not see renal disease in my practice but I am not a nephrologist.

      • Joan O’Brien-Singer
        10/28/2022 (8:37 am)

        My nephrologist is willing to even think about the Lyme connection with CKD, and now in my research I am reading that chronic Lyme can also cause thyroid issues which I have also. However, CKD can cause that too.But there are too many coincidences that I am seeing such as friends with Lyme who have morphed into MS or Parkinson’s. Reading “Bitten”by Kris Newby suggested by Ross Douthat- after reading his book “The Deep Places”. Both books are excellent. But, Dr. C. (And I miss you dreadfully, btw) there has to be some kind of connection or causal issues with Lyme and CKD, MS and Parkinson’s. When I lived in NY, my equine vet had many Lyme relapses and was quite ill. He retired – was diagnosed with Parkinson’s – – “Bitten” does talk about these connections. Sorry if I am being obstinate.

    • Joanne B
      11/20/2018 (12:16 pm)

      I am 64 year old female who has also been been diagnosed with cystic kidney disease; incidental finding of cysts in my kidneys and liver on an abdominal CT for other symptoms. My kidney function labs are WNL. I have had Lyme disease and Babesiois for 24 years but not treated promptly. Seeing geneticist currently to test for genetic mutation for PKD, however there is no one in my family with it now I am curious about the connection with Lyme.

      • Dr. Daniel Cameron
        11/20/2018 (1:49 pm)

        Dogs with tick borne illnesses commonly present with severe renal disease. I have not seen the same problem in humans. I posted a review of the article to encourage professionals to take a second look at the topic.

      • Jay Miller
        07/31/2020 (3:09 pm)

        Hi Joanne. My son has the genetic mutation of PKD with no family history. Did you ever make the connection with Lyme?


      • Minnie
        09/29/2021 (4:42 am)

        Definitely trigger by Lyme. I have witnessed first-hand but medical community is denial.

  • Valerie Sharlow
    09/13/2018 (9:05 pm)

    My 54 year old brother was just diagnosed with stage 4 chronic kidney disease in Syracuse, NY. His doctor told him that it was caused by his Lyme disease. He has been healthy his entire life until this past year. He is meeting with a transplant team next week. I hope to donate a kidney to him if at all possible…but i’m worried about his heart.. If the Lyme attacked his kidneys, then it may have done damage to other organs as well.

    • Dr. Daniel Cameron
      09/14/2018 (1:02 am)

      Kidney disease is well documented in dogs. I don’t see renal issue with Lyme disease in my practice. There may be other issues that led the doctor to consider Lyme disease. You may want to include a doctor experienced in treating Lyme disease in your evaluation in case it is a factor.

    • Wesley Sutton
      08/26/2020 (2:46 pm)

      Hey how did they go about treating his Lyme diease with kidney problems also? I have Lyme diease but scared to treat because of kidney problems thanks

  • Alison Pinkston
    01/30/2018 (6:49 pm)

    Interesting! I was diagnosed with Lyme and chronic kidney disease simultaneously in 2013. No cause for my CKD has been identified (no high blood pressure, diabetes, etc – generally healthy). CKD hasn’t improved with Lyme treatment but hasn’t really worsened either – just high creatinine & low gfr. Lyme symptoms improved greatly but didn’t disapper completely with treatment, CKD has been holding fairly steady – not improved. I now live in an area where Lyme is very rare so just get puzzled looks when I mention it to doctors here – would be interesting and perhaps beneficial to get involved in research on this matter.

    • Dr. Daniel Cameron
      02/01/2018 (12:50 am)

      I could find very little information on kidney disease in humans. It is a common problem in dog.

    • Giselle Sherman
      12/08/2019 (7:15 pm)

      Sadly, last year my kidney issues were labeled as kidney disease as well and I also have Lyme Disease and Babesia. This year was a horrible year for me as I had 4 kidney incidents and they are becoming more and more frequent. My Nephrologist said she thinks my kidney disease is directly linked to my Lyme Disease however she said she wasn’t Lyme literate and needed to research to figure out how to help me….

      • Dr. Daniel Cameron
        12/09/2019 (9:33 am)

        Dogs frequently have kidney disease or kidney failure due to tick borne illnesses. I have not seen kidney problems in my practice. Perhaps other have.

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