Kidney Week

Abstract: FR-PO0987

Seroprevalence of Strongyloides stercoralis in Patients on Hemodialysis

Session Information

• Transplantation: Clinical - Pretransplantation, Living Donation, and Policies
  November 07, 2025 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Transplantation

• 2102 Transplantation: Clinical

Authors

• Gerges, Daniela, Division of Nephrology and Dialysis, Department of Medicine III, Medical University of Vienna, Vienna, Austria

Daniela Gerges, MD, MSc, PhD

• Omic, Haris, Division of Nephrology and Dialysis, Department of Medicine III, Medical University of Vienna, Vienna, Austria

Haris Omic, MD

• Veletzky, Luzia, Division of Infectious Diseases and Tropical Medicine, Department of Medicine I, Medical University of Vienna, Vienna, Austria

Luzia Veletzky, MD, PhD

• Mahdi Nour Ali, Yassan, Division of Nephrology and Dialysis, Department of Medicine III, Medical University of Vienna, Vienna, Austria

Yassan Mahdi Nour Ali, MD

• Hoffmann, Simon, Division of Nephrology and Dialysis, Department of Medicine III, Medical University of Vienna, Vienna, Austria

Simon Hoffmann, MD

• Abd El-Ghany, Karim, Division of Nephrology and Dialysis, Department of Medicine III, Medical University of Vienna, Vienna, Austria

Karim Abd El-Ghany

• Egger, Isabella, Department of Medicine III, Clinic Donaustadt, Vienna, Austria

Isabella Egger, MD

• Eigner, Manfred, Department of Medicine I with Nephrology, Intensive Care Medicine, Psychosomatic and Diabetology, Clinic Favoriten, Vienna, Austria

Manfred Eigner, MD

• Jabbour, Rhea, Division of Nephrology and Dialysis, Department of Medicine III, Medical University of Vienna, Vienna, Austria

Rhea Jabbour, MD

• Jansen, Martin, Krankenhaus Barmherzige Brüder, Department of Medicine I,, Vienna, Austria

Martin Jansen, MD

• Lorenz, Matthias, Wiener Dialysezentrum, Vienna, Austria

Matthias Lorenz, MD

• Ludvik, Bernhard, Department of Medicine I Diabetology, Endocrinology, Nephrology, and Karl Landsteiner Institute for Obesity and Metabolic Disorders, Landstrasse Clinic, Vienna, Austria

Bernhard Ludvik, MD

• Saemann, Marcus D., Department of Medicine VI with Nephrology and Dialysis, Clinic Ottakring, Vienna, Austria

Marcus D. Saemann, MD

• Stulnig, Thomas, Department of Medicine III and Karl Landsteiner Institute for Metabolic Diseases and Nephrology, Clinic Hietzing, Vienna, Austria

Thomas Stulnig, MD

• Tobudic, Selma, Division of Infectious Diseases and Tropical Medicine, Department of Medicine I, Medical University of Vienna, Vienna, Austria

Selma Tobudic, MD

• Werzowa, Johannes, Division of Nephrology, Department of Medicine I, Hanusch-Krankenhaus, Vienna, Austria

Johannes Werzowa, MD

• Walochnik, Julia, Research Unit Molecular Parasitology, Institute of Specific Prophylaxis and Tropical Medicine, Centre for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria

Julia Walochnik, MD

• Wagner, Ludwig, Division of Nephrology and Dialysis, Department of Medicine III, Medical University of Vienna, Vienna, Austria

Ludwig Wagner

• Watschinger, Bruno, Division of Nephrology and Dialysis, Department of Medicine III, Medical University of Vienna, Vienna, Austria

Bruno Watschinger, MD

• Winnicki, Wolfgang, Division of Nephrology and Dialysis, Department of Medicine III, Medical University of Vienna, Vienna, Austria

Wolfgang Winnicki, MD

Background

Strongyloides stercoralis (S. stercoralis) is a parasitic infection endemic to tropical areas. Its prevalence is rising in Europe. In kidney transplant (KTX) recipients, corticosteroids can cause hyperinfection syndrome, marked by accelerated autoinfection, high parasite burden, hyperinflammation, and sepsis. Hyperinfection syndrome can be prevented with a short course of ivermectin. Given this risk, routine S. stercoralis screening in KTX candidates is warranted. We assessed S. stercoralis prevalence in all hemodialysis patients with end-stage renal disease in Vienna, Austria.

Methods

Blood samples were collected from all consenting hemodialysis patients (N=704) and tested for IgG-antibodies via ELISA. A questionnaire assessed soil exposure, medical history, transplant status, travel, helminthic symptoms, and immunosuppressive therapy. Positive serologies were reanalyzed by the Austrian reference center for parasitosis; three stool samples were examined for eggs/larvae.

Results

Of the 704 patients, 116 (16.1%) had a history of organ transplantation. IgG antibodies against S. stercoralis were found in 50 patients (6.9%), including four with a prior KTX. No significant differences were observed between IgG-positive and negative patients regarding travel to endemic areas, pet ownership, soil contact, symptoms of helminthic infection, immunosuppressant use, or history of KTX (p-values: 0.76, 0.19, 0.15, 0.95, 0.96, 0.22, respectively). Patients from Western Europe were less likely to be IgG-positive (p=0.02), while those from the Middle East & North Africa (MENA) were more likely to test positive (p=0.03). Serum-IgE and CRP levels did not predict IgG presence, but absolute and relative eosinophilia were significantly associated with IgG positivity, with cut-offs of ≥0.19G/L and ≥1.95%, respectively ([AUC=0.87 (0.81–0.92)], [AUC=0.84 (0.79–0.90)]).

Conclusion

S. stercoralis prevalence has been underestimated and is rising globally. Due to the risk of hyperinfection syndrome and the growing immunocompromised population, screening should be included in pre-KTX protocols—especially in patients from MENA regions or with absolute eosinophil counts ≥0.19G/L.

Funding

• Government Support – Non-U.S.

Digital Object Identifier (DOI)

• doi: 10.1681/ASN.2025atsn1byy