Oliguric and non-oliguric acute renal failure in malaria in west zone of rajasthan, India-A comparative study

Gupta, Bal Kishan; Nayak, Kailash Chandra; Kumar, Sunil; Kumar, Surendra; Gupta, Ajay; Prakash, Parul

doi:10.1016/s2221-6189(13)60024-4

Cited by 6 publications

(6 citation statements)

References 13 publications

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“…We found that 60% of malarial ARF were due to vivax infection and 30% due to falciparum . Gupta et al 22 studied 74 patients of ARF in Bikaner and found that 70% of malarial ARF was due to P. falciparum , 18.9% due to P. vivax , and 10.8% due to mixed infection. Prakash et al 23 studied 94 patients of malarial ARF in Varanasi and found that 80.9% of malarial ARF was due to P. falciparum and 11.7% due to P. vivax .…”

Section: Discussionmentioning

confidence: 99%

Clinical Profile and Prognostic Indicators in Adults Hospitalized with Severe Malaria Caused by Different Plasmodium Species

Gupta

Nehra

et al. 2015

Infect Dis (Auckl)

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INTRODUCTIONSevere malaria remains a major cause of death and morbidity among adults in the Asiatic tropics. This study was planned to evaluate clinical profile and prognostic indicators of severe malaria in adults so as to improve insight into this highly prevalent disease.MATERIALS AND METHODSThis prospective observational study was conducted on 60 confirmed cases of malaria. Cases were divided into two groups: (a) study group: suffering from severe malaria and (b) control group: no severe manifestations. All cases were thoroughly studied for clinical features, laboratory evaluation, and outcome. Prognostic evaluation was also done by different score systems.RESULTSIn all, 40 cases suffer from severe malaria (study group), while 20 cases belong to the control group. The majority of our cases were males of age 21–40 years. The most common species of malaria in the study group was vivax (52.5%), followed by falciparum (25%) and mixed malaria species (22.5%). The clinical predictors for severe malaria were rural habitat, longer duration of fever, marked chills, tiredness, giddiness, nausea, vomiting, decreased urine output, jaundice, and altered sensorium. Extreme weakness (80%), jaundice (55%), renal failure (50%), and severe anemia (27.5%) were the most common presenting features in severe malaria. Two patients died of severe mixed malaria. The mortality rate was significantly associated with lower hemoglobin level (P = 0.002); higher total leukocyte count (P = 0.006), blood urea (P < 0.001), serum creatinine (P < 0.001), SGOT (P = 0.001), SGPT (P < 0.007), serum bilirubin (P = 0.003), and parasite density (P = 0.033); lower platelet count (P = 0.043); and those who had more APACHE II score (P = 0.003), SOFA score (P = 0.04), and Multiple Organ Dysfunction Score (P < 0.001) and lower Glasgow Coma Scale (P < 0.001).CONCLUSIONSManifestations of severe malaria is becoming increasingly more prevalent specifically in vivax and mixed malaria cases. Our study proposes that there are certain clinical predictors and prognostic indicators that should be kept in mind for better management of severe malaria.

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Section: Discussionmentioning

confidence: 99%

Clinical Profile and Prognostic Indicators in Adults Hospitalized with Severe Malaria Caused by Different Plasmodium Species

Gupta

Nehra

et al. 2015

Infect Dis (Auckl)

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“…Three studies from India also reported similar findings. 10,11,12 Anaemia was observed in 57 (47.5%) patients in our study, out of which severe anaemia was present in 8 (6.67%) cases. Two studies also reported similar incidence of severe anaemia.…”

Section: Discussionmentioning

confidence: 45%

“…16,17 However Sitprija V, Murthy G and Gupta BK reported lower incidence of AKI in their study. 10,12,18 Krishnan reported higher incidence of AKI (89%) in his study. 1 Oliguric kidney injury was more common (20.83%) than non-oliguric injury in our study (13.33%).…”

Section: Discussionmentioning

confidence: 71%

Clinical Profile of Falciparum Malaria With Special Reference to Acute Kidney Injury- A Hospital-Based Observational Study

Baruah¹,

Buragohain²

2018

jemds

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BACKGROUND Malaria is very frequent in our state and acute kidney injury is a frequent complication. The objectives of this study were to evaluate the clinical features of falciparum malaria and its impact on kidney functions and the short-term outcomes. MATERIALS AND METHODS This was a hospital-based observational study, where 120 falciparum cases were studied in detail in a period of one year. A detailed history, thorough clinical examination and relevant investigations were done in patients suffering from falciparum malaria. AKIN criteria were used to define acute kidney injury. RESULTS Fever was the most common clinical feature which was present in 100% of the patients and associated chills and rigors were seen in 95.8% cases. 70.83% cases were complicated (severe) falciparum malaria and rest of 29.16% cases were uncomplicated. Acute kidney injury was seen in 34.16% patients. About 46.4% patients were in stage 3 AKIN. 60.9% cases required haemodialysis. There was 13.33% mortality in our study due to falciparum malaria. Malarial AKI attributed to 24.39% of the mortality. CONCLUSION Among the complicated cases, most of the patients had malarial acute kidney injury and required haemodialysis. Majority of the AKI patients presented with oliguria and albuminuria. Mortality was higher in patients with acute kidney injury.

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“…Reports of renal biopsies from patients with MARF are scarce and mostly originate from India [17, 18]. One biopsy series of 20 patients with MARF found either ATN, mesangioproliferative glomerulonephritis or a combination of both [17]. Prakash et al [18] reported a series of 6 MARF biopsies which revealed 1 necrotising glomerulonephritis while the other five had ATN.…”

Section: Discussionmentioning

confidence: 99%

Acute interstitial nephritis with podocyte foot-process effacement complicating Plasmodium falciparum infection

Gleeson

O’Regan

McHale

et al. 2019

Malar J

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Background Malarial acute renal failure (MARF) is a component of the severe malaria syndrome, and complicates 1–5% of malaria infections. This form of renal failure has not been well characterized by histopathology. Case presentation A 44 year-old male presented to the emergency department with a 5-day history of fever and malaise after returning from Nigeria. A blood film was positive for Plasmodium falciparum . His creatinine was 616 µmol/L coming from a normal baseline of 89 µmol/L. He had a urine protein:creatinine ratio of 346 mg/mmol (4.4 g/L). He required dialysis. A renal biopsy showed acute interstitial nephritis with podocyte foot-process effacement. He was treated with artesunate and his renal function improved. At 1 year follow-up his creatinine had plateaued at 120 µmol/L with persistent low-grade proteinuria. Conclusion Acute interstitial nephritis and podocyte foot-process effacement might be under-recognized lesions in MARF. Studying the mechanisms of MARF could give insight into the immunopathology of severe malaria.

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Oliguric and non-oliguric acute renal failure in malaria in west zone of rajasthan, India-A comparative study

Cited by 6 publications

References 13 publications

Clinical Profile and Prognostic Indicators in Adults Hospitalized with Severe Malaria Caused by Different Plasmodium Species

Clinical Profile and Prognostic Indicators in Adults Hospitalized with Severe Malaria Caused by Different Plasmodium Species

Clinical Profile of Falciparum Malaria With Special Reference to Acute Kidney Injury- A Hospital-Based Observational Study

Acute interstitial nephritis with podocyte foot-process effacement complicating Plasmodium falciparum infection

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