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"

  • Jo Ann Clay
    06/06/2023 (3:45 am)

    I am 74 and have had Lyme Disease since 2004. I was just Dx with Stage 4 Kidney Disease. We found the tick, had the “bull’s eye rash” and tested positive for Lyme. Dr Charles Crist in Missouri saved my life! I also lost vision in my R eye from it several years later.

  • Eydie potter
    01/27/2022 (12:51 pm)

    My bun number is 25 and my gfr is 54. I am 68 years old A year in a half ago I got a positive igm for Lyme and had 4 bands in igg I am in month 13 of treatment. My resting hr has increased from 60 to 75. This must be due to decreased kidney function

    • Dr. Daniel Cameron
      01/28/2022 (8:24 am)

      I also have patients in my practice with renal issues who have underlying Lyme disease.

  • Shane
    04/25/2021 (4:48 am)

    I have been diagnosed with M.S. & given minutes to live 10 years ago. I was also diagnosed with Lyme disease. When I take things like cats claw, motherwort or black walnut my kidneys will be in pain for days which is unusual for me. Is this a die off reaction? I’m wondering if either:
    A) Lymes has parked itself in my kidneys or
    B) the kidneys can’t filter out the die off fast enough?
    Any ideas?

    • Dr. Daniel Cameron
      04/25/2021 (7:57 am)

      I am not sure what is happening. I would typically refer my patient to a neurologist as part of my evaluation.

  • SueK
    07/07/2020 (10:32 pm)

    Dr Cameron this article is very interesting. My child who was recently diagnosed with Lyme has had a host of issues in the bladder, kidney, appendix reoccurring. She is now 10. I think she was misdiagnosed at age 3 with ring worm instead of Lyme on her trunk I recall the Circle rash (Not target) and immediately took her to the doctor. I worry about the best treatment for her as she has so much life left. She also has neurological side effects, fatigue, vision issues, a host of otherS. We live in Northwest Indiana near Chicago. Keep doing your work we need you. Wish we were closer so we could participate in studies and research.

  • Rebecca
    05/19/2020 (9:26 am)

    My son had a 3 mm kidney stone at age 4. They said it was caused by high oscillates, but every follow up lab over the next 12 months showed no elevated levels. He was also developing behavior challenges (anger outbursts, anxiety-driven behaviors) around that time. He was finally diagnosed with Lyme and several coinfections at around age 7-1/2. Our Lyme doc didn’t seem surprised to hear about the stone, or that occilates were never found in the follow up nephrology lab-work.

    • Dr. Daniel Cameron
      05/19/2020 (11:50 am)

      I am happy to hear your child was eventually treated. I can’t help you on the stone question.

    • Minnie
      09/29/2021 (4:39 am)

      A group of friends got Lyme a decade ago, they all now have kidney disease. One just died. Kidney disease is definitely triggered by Lyme. They all also have thyroid disease and eye issues. Sadly although diagnosed with Lyme they only received two weeks of doxy. Fast forward they now know that is not sufficient treatment for Lyme

      • Joan O’Brien-Singer
        10/28/2022 (8:25 am)

        Wow- Your situation sounds so similar to my issues. I am in stage 4CKD but was only diagnosed when I reached stage 3. Seems that my former Primary care doctor didn’t think that my slow Gfr drop was anything to worry about because I was getting old. I finally found an amazing Primary care Doc who was very concerned about my raising creatinine and BUN along with my falling Gfr. He immediately referred me to a nephrologist whom I adore by the way. He is willing to consider the connection of CKD and chronic Lyme. I also have thyroid issues now Hi Pth which I understand Chronic Lyme can cause too, I just finished 8 weeks of antibiotic treatment for an eye infection which my eye doc considered a viral infection-said there were no eye anti-virals for what I had. Funny thing-I had a cat with ocular herpes that was given a powerful anti viral and antibiotic at the same time which worked like a charm. It’s very hard to find LLMDs here that take Medicare or health insurance for Lyme treatment. Antibiotics don’t work much for me anymore but symptoms persist and are very painful. From your post I feel validated. thank you.

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