Insuffisance rénale aiguë dans les formes graves du paludisme chez les enfants vivant à Kinshasa

Kunuanunua, T.S.; Nsibu, Célestin Ndosimao; Gini-Ehungu, Jean-Lambert; Bodi, Joseph M.; Ekulu, Pépé Mfutu; Situakibanza, Hippolyte; Nseka, Nazaire Mangani; Magoga, Kumbundu; Aloni, Michel Ntetani

doi:10.1016/j.nephro.2013.01.001

Cited by 28 publications

(25 citation statements)

References 33 publications

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“…NoECM LP which is a milder form of malaria presented less renal impairment than ECM and NoECM HP . The impact of K173 infection in this model is close to that observed in human malaria [52,59,61,62]. Hypoglycemia, acidosis and renal failure observed in this rat model are the main WHO criteria to define severe forms of malaria [4].…”

Section: Resultssupporting

confidence: 52%

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Young Sprague Dawley rats infected by Plasmodium berghei: A relevant experimental model to study cerebral malaria

et al. 2017

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Cerebral malaria (CM) is the most severe manifestation of human malaria yet is still poorly understood. Mouse models have been developed to address the subject. However, their relevance to mimic human pathogenesis is largely debated. Here we study an alternative cerebral malaria model with an experimental Plasmodium berghei Keyberg 173 (K173) infection in Sprague Dawley rats. As in Human, not all infected subjects showed cerebral malaria, with 45% of the rats exhibiting Experimental Cerebral Malaria (ECM) symptoms while the majority (55%) of the remaining rats developed severe anemia and hyperparasitemia (NoECM). These results allow, within the same population, a comparison of the noxious effects of the infection between ECM and severe malaria without ECM. Among the ECM rats, 77.8% died between day 5 and day 12 post-infection, while the remaining rats were spontaneously cured of neurological signs within 24–48 hours. The clinical ECM signs observed were paresis quickly evolving to limb paralysis, global paralysis associated with respiratory distress, and coma. The red blood cell (RBC) count remained normal but a drastic decrease of platelet count and an increase of white blood cell numbers were noted. ECM rats also showed a decrease of glucose and total CO2 levels and an increase of creatinine levels compared to control rats or rats with no ECM. Assessment of the blood-brain barrier revealed loss of integrity, and interestingly histopathological analysis highlighted cyto-adherence and sequestration of infected RBCs in brain vessels from ECM rats only. Overall, this ECM rat model showed numerous clinical and histopathological features similar to Human CM and appears to be a promising model to achieve further understanding the CM pathophysiology in Humans and to evaluate the activity of specific antimalarial drugs in avoiding/limiting cerebral damages from malaria.

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Section: Resultssupporting

confidence: 52%

“…High levels of creatinine, observed principally in ECM and NoECM HP rats, have also been reported in children suffering of CM in Africa where hypercreatinemia was reported to be a risk factor of mortality [37,51]. This increase could be linked to renal failure also described in severe malaria [2,52]. …”

Section: Resultsmentioning

confidence: 85%

Young Sprague Dawley rats infected by Plasmodium berghei: A relevant experimental model to study cerebral malaria

et al. 2017

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“…Although AKI is recognized as a relatively common complication in adults with SM, the incidence of AKI in children with malaria has not been systematically assessed with longitudinal assessment of Cr over hospitalization. Malaria is a major infection-related cause of AKI in malaria-endemic areas [ 6 , 7 , 24 – 26 ], but there are limited data on the incidence of AKI in pediatric SM with estimates ranging from 3% to 31% [ 6 , 7 , 27 , 28 ]. In this study, we prospectively assessed the incidence of AKI in a cohort of children randomized to iNO or placebo as an adjunctive therapy for SM.…”

Section: Discussionmentioning

confidence: 99%

Acute Kidney Injury Is Common in Pediatric Severe Malaria and Is Associated With Increased Mortality

Conroy

Hawkes

Elphinstone

et al. 2016

Open Forum Infectious Diseases

107

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“…Our study reports an intra-hospital prevalence of ARF during malaria in children of 0.78%. In the literature, prevalences ranging from 0.3% to 30.4% have been reported [7,9,12,14] . The frequency of ARF in malaria varies depending on the location of patient recruitment.…”

Section: Discussionmentioning

confidence: 99%

“…Data on ARF in childhood malaria in the Democratic Republic of Congo (DRC) are sparse. With the aim of documenting the profile of ARI during malaria in pediatric hospitals in Kinshasa, a study showed that it represented 23.6%, dialysis was performed in 24.0%, and the mortality rate was 12.6% [14] . In Lubumbashi, a pediatric case of ARF during malaria was treated in a logistically under-equipped setting.…”

Section: Introductionmentioning

confidence: 99%

Acute renal failure as severe malaria complication in Lubumbashi: Management and follow-up in an under-equipped setting

Kalonji

Kembo²,

Ngombe

et al. 2020

Adv Gen Pract Med

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Purpose Acute renal failure (ARF) or acute kidney injury (AKI) is one of the major criteria for the severity of malaria according to WHO. The objective was to determine the frequency as well as to evaluate the management and follow-up of ARF during malaria in children in Lubumbashi. Material and methods This is a descriptive cross-sectional study over 48 months (January 1st, 2016 to December 30th, 2019) carried out at the pediatric service of the University Clinics of Lubumbashi. All children with an ARF with a positive thick blood smear were included in the study. Data were analyzed with SPSS 19 software. Results During this period, 910 patients (49.1%) were admitted for malaria. Among them, 14 patients, i.e. an intra-hospital prevalence of 0.78%, of which 6 boys (42.9%) and 8 girls (57.1%) had ARF. The mean age is 7.9±3.5 years. The serum creatinine level was between 0.54 and 15.2 mg/dL with a mean of 5.7 mg/dL. Kidney dialysis was only effective in 3 patients (21.4%) and diuretics were given 100% in all children. The mean length of stay was 13.4±8.7 days (range: 1 day and 18 days). Mortality was 21.4%. Conclusion The present study shows that ARF in childhood malaria in Lubumbashi is infrequent but of high mortality in our environment with limited resources where care is lacking and monitoring difficult.

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Insuffisance rénale aiguë dans les formes graves du paludisme chez les enfants vivant à Kinshasa

Cited by 28 publications

References 33 publications

Young Sprague Dawley rats infected by Plasmodium berghei: A relevant experimental model to study cerebral malaria

Young Sprague Dawley rats infected by Plasmodium berghei: A relevant experimental model to study cerebral malaria

Acute Kidney Injury Is Common in Pediatric Severe Malaria and Is Associated With Increased Mortality

Acute renal failure as severe malaria complication in Lubumbashi: Management and follow-up in an under-equipped setting

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