Renal Failure in Malaria

Sitprija, Visith; Indraprasit, Suchati; Pochanugool, C; Benyajati, C.; Piyaratn, Prapont

doi:10.1016/s0140-6736(67)91825-9

Cited by 56 publications

(31 citation statements)

References 7 publications

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“…Sitpriza et al in their study of 163 malarial patients found the major causes of mortality were multiorgan failure in 12 (57.14%), pulmonary edema in 6 (28.57%), ARDS in 2 (9.52%) and massive GI bleed one patient. 18 This supports our study.…”

Section: Discussionsupporting

confidence: 88%

Study of epidemiological profile, clinico-biochemical spectrum and prognosis of malaria induced renal dysfunction in paediatrics age group

Panwar

Soni

Ahmed

2016

Int J Contemp Pediatr

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INTRODUCTIONMalaria remains a serious health problem in many parts of the world. It causes high morbidity and claims many lives in developing countries each year. Humans are generally infected by four species of malaria parasites. 1Malarial acute kidney injury is commonly found in nonimmune adults and older children with falciparum malaria and occasionally with Plasmodium vivax. Occurrence of malaria induced acute kidney injury in severe falciparum malaria is quite common in Southeast Asia and Indian subcontinent where intensity of malaria transmission is usually low.2 Major manifestations of severe malaria in children are cerebral malaria, severe ABSTRACTBackground: Aim of current study was to assess the epidemiology, clinico-biochemical spectrum and prognosis of acute malaria induced nephropathy in children. Methods: This was a prospective study conducted in the period from November 2013 to November 2014 in children suffering from acute malaria induced acute kidney injury. Malaria was confirmed by peripheral blood film or Rapid malaria test and detailed clinical evaluation and investigations were carried out to find multi-organ afflictions with special emphasis on renal involvement. Results: Out of total 200 cases with malaria recorded in our hospital 60 (30%) cases had acute malaria induced acute kidney injury caused by Plasmodium vivax in 45 (75%), Plasmodium falciparum in 3 (5%) and mixed infection in 12 (20%) cases. Thirty percentage of cases had come from Sri Ganganagar district making it the most common geographical region in our study. The sex ratio was 3.6:1. Most common age group was 5-10 year age group contributing to 45% of the cases. Fever and oliguria being the most common presentation and was observed in all the cases followed by vomiting, pain abdomen and hypotension which was present in 33%, 32% and 20% of the cases respectively. Oliguria was present in all the cases in which 24 (40%) cases had urine output <1 ml/kg/hour, 36 (60%) patient had urine output <0.5 ml/kg/hour with G.F.R >25 ml/min/1.73m 2 and <25 ml/min/1.73m 2 seen in 40 (66%) and 3 (5%) cases respectively. Fifty five patients (91.66%) had S. creatinine between 1.5-3 mg/dl and only 5 patients (8.33%) had serum creatinine >3 mg/dl. 75% cases recovered in <5 days and 4 patients expired, 2 due to respiratory failure and 2 due to MODS and cerebral malaria. expired cases two were died due to respiratory failure, other two were died due to multiorgan failure and cerebral malaria. Conclusions: The spectrum of renal involvement due to malaria is variable ranging from mild derangement of renal functions to advanced stage of renal dysfunction which needs immediate dialysis. Severe renal involvement was mainly seen with P. falciparum but in our study it is mainly seen with P. vivax infection.

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Section: Discussionsupporting

confidence: 88%

Study of epidemiological profile, clinico-biochemical spectrum and prognosis of malaria induced renal dysfunction in paediatrics age group

Panwar

Soni

Ahmed

2016

Int J Contemp Pediatr

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“…2,3 Hypotension in this patient could have arisen from a negative fluid balance, probably from inadequate fluid intake caused by illness, increased insensible loss from fever, or other causes. 7 Although pathophysiology of P. knowlesi-associated acute renal failure in human remains unknown, the clinical course of such severe complication in knowlesi malaria seems to be reminiscent to that in falciparum malaria in terms of a short duration of rising levels of serum creatinine and rapid return to normal with effective antimalarial treatment. [7][8][9] Acute renal failure in falciparum malaria is usually associated with hypovolemia, hyperparasitemia, high blood viscosity, and renal hypoperfusion.…”

Section: Discussionmentioning

confidence: 99%

“…7 Although pathophysiology of P. knowlesi-associated acute renal failure in human remains unknown, the clinical course of such severe complication in knowlesi malaria seems to be reminiscent to that in falciparum malaria in terms of a short duration of rising levels of serum creatinine and rapid return to normal with effective antimalarial treatment. [7][8][9] Acute renal failure in falciparum malaria is usually associated with hypovolemia, hyperparasitemia, high blood viscosity, and renal hypoperfusion. 8 Recent studies have shown that liberal fluid resuscitation does not improve acid-base balance and renal function in severe falciparum malaria, whereas inappropriate fluid replacement may exacerbate pulmonary edema.…”

Section: Discussionmentioning

confidence: 99%

An Autochthonous Case of Severe Plasmodium knowlesi Malaria in Thailand

Nakaviroj¹,

Kobasa²,

Teeranaipong³

et al. 2015

The American Society of Tropical Medicine and Hygiene

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Abstract.A 58-year-old Thai man was infected with Plasmodium knowlesi in Chantaburi Province, eastern Thailand. In addition to pyrexia, the patient developed hypotension, renal failure, jaundice, and severe thrombocytopenia. The parasitemia at the time of admission was 16.67% or~503,400 parasites/μL. With artesunate treatment and supportive care, the patient recovered uneventfully. The occurrence of complicated knowlesi malaria in a low-endemic area underscores the risk of high morbidity from this simian malaria.

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“…The administration of excessive parenteral fluid to such a patient during the period of unrecognized impaired renal function can easily lead to pulmonary edema and acute water intoxication. 20 Early diagnosis, prompt treatment with antimalarial drugs, and recognition of complications can reduce the mortality rate of severe falciparum malaria. Since ARF frequently predisposes patients to pulmonary edema and sepsis, it is critical that ARF be promptly recognized and aggressively treated by techniques such as dialysis.…”

Section: Discussionmentioning

confidence: 99%

“…Moderate renal impairment is usually transient and reversible following rehydration and antimalarial treatment. 20 The duration of renal failure varies from a few days to several weeks.…”

Section: Discussionmentioning

confidence: 99%

Treatment of malarial acute renal failure by hemodialysis.

Wilairatana¹,

Westerlund²,

Aursudkij³

et al. 1999

The American Journal of Tropical Medicine and Hygiene

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Abstract. We studied 112 patients with malarial acute renal failure (ARF) during the period 1991-1997 at Bangkok Hospital for Tropical Diseases (Mahidol University, Bangkok, Thailand). Hemodialysis was performed in 101 (90.2%) of these patients. The mean number of times the patients were hemodialyzed was 6.5 (range ϭ 1-27). Ninety-three (83.0%) patients were oliguric and the remainder were nonoliguric. Patients who had oliguric renal failure required more hemodialyses and had more complications than the nonoliguric patients. The oliguric patients had an eight-fold higher risk of requiring six or more hemodialyses (95% confidence interval ϭ 1.2-53.9, P ϭ 0.0008). The overall mortality rate was 10.7% (12 of 112). Eleven of the patients who died were jaundiced and eight of them had cerebral malaria with a Glasgow Coma Score Յ 8. We conclude that hemodialysis is a useful treatment for oliguric and nonoliguric ARF from severe malaria, particularly when initiated early in the course of the illness.Malaria remains one of the world's major health problems, particularly in the tropics. Currently, it affects more than 200 million individuals and 1-2 million people die of the disease each year.

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Renal Failure in Malaria

Cited by 56 publications

References 7 publications

Study of epidemiological profile, clinico-biochemical spectrum and prognosis of malaria induced renal dysfunction in paediatrics age group

Study of epidemiological profile, clinico-biochemical spectrum and prognosis of malaria induced renal dysfunction in paediatrics age group

An Autochthonous Case of Severe Plasmodium knowlesi Malaria in Thailand

Treatment of malarial acute renal failure by hemodialysis.

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