Indian Journal of Public Health Research & Development

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Renal Complications in Malaria


Affiliations
1 Institute of Nephro-Urology, Victoria Hospital Campus, Bangalore, India
2 Department of Community Health, St. John's Medical College, Bangalore, India
3 Department of Medicine, Victoria Hospital (Bangalore Medical College and Research Institute), KR Road, Bangalore, India
     

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Background: The clinical manifestation of malaria has changed with more patients presenting with systemic manifestations. Malarial acute renal failure (MARF) is an emerging problem associated with high morbidity and mortality, but can be diagnosed and treated during the early stages.

Objectives: To

(1) describe the biochemical renal parameters among malaria patients and

(2) study the association between biochemical renal parameters and plasmodium species.

Method: 50 adult in-patients, who were diagnosed to be affected by malaria and utilizing the health facilities of a teaching medical college hospital in Bangalore and those who consented and satisfied the inclusion criteria, were included in the study. Detailed history, general physical and systemic examination and necessary pathological, biochemical renal laboratory parameters and radiological investigations were done.

Results: Among the 50 patients, 37 (74%) were males and 13 (26%) were females. Thirty seven (74%) patients were infected with P. falciparum, nine (18%) were infected with P. vivax and four (8%) had mixed infections. Twenty three (46%) patients had increased blood creatinine of more than 3mg/dL and urine output of less than 400 ml/day were classified as suffering from malaria acute renal failure (MARF) and among those with MARF 17 (73.91%) had P. falciparum infection, two (8.69%) had P. vivax infection and four (17.39%) had mixed infection.

Conclusion: People infected with P. falciparum or mixed infections are at an increased risk of developing acute renal failure when compared to people infected with P. vivax. Alteration in blood urea, serum albumin and serum electrolytes are other early features suggestive of MARF.


Keywords

Malaria, Plasmodium Species, Acute Renal Failure
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  • Wikipedia, The Free Encyclopedia. Malaria. [Online]. [2008] [cited 2008 Apr 18]; Available from: URL:http://en.wikipedia.org/wiki/ Malaria

  • Manan JA, Ali H, Lal M. Acute renal failure associated with malaria. J Ayub Med Coll 2006;18(4). p. 47-52

  • Malaria: what is malaria? [Online]. [2007 Jan 9] [cited 2008 Apr 18]; Available from: URL: http:/ /www.searo.who.int/EN/Section10/Section21/ Section334.htm

  • Malaria: historical background. [Online]. [2007 Jan 9] [cited 2008 Apr 18]; Available from: URL:http://www.searo.who.int/EN/ Section10/Section21/Section334_4008.htm

  • Prakash J, Singh AK, Gujrati S, Maheshwari A, Acute renal failure in malaria: changing trends. Indian J Nephrol 2002;12:113-7.

  • Mishra SK, Mohapatra S, et al. Acute renal failure in falciparum malaria. J Indian Acad Clin Med 2002 Apr-Jun;3(2):141-7.

  • Kanodia KV, Shah PR, Vanikar AV, Kasat P, Gumber M, Trivedi HL. Malaria induced acute renal failure: A single center experience. Saudi J Kidney Dis Transpl [serial online] 2010 [cited 2011 Mar 2]; 21:1088-91. Available from: http:// www.sjkdt.org/text.asp?2010/21/6/1088/72296

  • Chugh KS. Glomerular disease associated with tropical infections. [Online] [cited 2011 Mar 2]. Available from URL: http://www.uninet.edu/ cin2000/conferences/chugh/chugh.html

  • Kochar DK, Sirohi P, Kochar SK. Malaria in India. Chapter 109. Association of Physicians of India. Update 2007. [Online]. 2007 [cited 2011 Mar 2]. Available from: URL: http://www.apiindia.org/ medicine_update_2007/109.pdf

  • Rajapurkar MM. Renal involvement in malaria. J Postgrad Med 1994;40(3):132-4.

  • Sitprija V. Nephropathy in falciparum malaria. Kidney International 1988;34:867-77.

  • Mehta KS, Halankar AR, Makwana PD, Torane PP, Satija PS, Shah VB. Severe acute renal failure in malaria. J Postgrad Med 2001;47(1):24-26. [cited 2011 Mar 2];47:24. Available from: http:// www.jpgmonline.com/text.asp?2001/47/1/24/ 243

  • Prakash J, Singh AK, Kumar NS, Saxena RK. Acute renal failure in Plasmodium vivax malaria. J Assoc Physicians India. 2003 Mar;51:265-7

  • Clark IA. Does endotoxin cause both the disease and parasite death in acute malaria and babesiosis? Lancet 1978;2:75-7.

  • Malloy JP, Brooks MH, Barry KG. Pathophysiology of acute falciparum malaria. Am J Med 1967;43:745-50.

  • Balcerak SP, Arnold JD, Martin DC. Anatomy of red cell damage by Plasmodium falciparum in man. Blood 1972;40:98-104.

  • Nand N, Aggarwal H, Sharma M, Singh M. Systemic manifestations of malaria. Journal, Indian Academy of Clinical Medicine. Jul-Sep 2001;2(3):189-94.

  • Park K. Park’s text book preventive and social medicine. 18th ed. Jabalpur (India): M/s Banarsidas Bhanot Publishers; 2005. p.210-5.

  • Barsoum SR. Malaria acute renal failure. J Am Soc Nephrol 2000;11:2147-54.

  • Wilairatana P, Westerlund EK, Aursudkij B, Vannaphan S, Rudsood S, Viriyavejakul P, et al. Treatment of malarial acute renal failure by hemodialysis. Am J Trop Med Hyg 1999; 60(2):233-7.


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  • Renal Complications in Malaria

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Authors

V Leelavathi
Institute of Nephro-Urology, Victoria Hospital Campus, Bangalore, India
R Naveen
Department of Community Health, St. John's Medical College, Bangalore, India
Veeranna Gowda
Department of Medicine, Victoria Hospital (Bangalore Medical College and Research Institute), KR Road, Bangalore, India

Abstract


Background: The clinical manifestation of malaria has changed with more patients presenting with systemic manifestations. Malarial acute renal failure (MARF) is an emerging problem associated with high morbidity and mortality, but can be diagnosed and treated during the early stages.

Objectives: To

(1) describe the biochemical renal parameters among malaria patients and

(2) study the association between biochemical renal parameters and plasmodium species.

Method: 50 adult in-patients, who were diagnosed to be affected by malaria and utilizing the health facilities of a teaching medical college hospital in Bangalore and those who consented and satisfied the inclusion criteria, were included in the study. Detailed history, general physical and systemic examination and necessary pathological, biochemical renal laboratory parameters and radiological investigations were done.

Results: Among the 50 patients, 37 (74%) were males and 13 (26%) were females. Thirty seven (74%) patients were infected with P. falciparum, nine (18%) were infected with P. vivax and four (8%) had mixed infections. Twenty three (46%) patients had increased blood creatinine of more than 3mg/dL and urine output of less than 400 ml/day were classified as suffering from malaria acute renal failure (MARF) and among those with MARF 17 (73.91%) had P. falciparum infection, two (8.69%) had P. vivax infection and four (17.39%) had mixed infection.

Conclusion: People infected with P. falciparum or mixed infections are at an increased risk of developing acute renal failure when compared to people infected with P. vivax. Alteration in blood urea, serum albumin and serum electrolytes are other early features suggestive of MARF.


Keywords


Malaria, Plasmodium Species, Acute Renal Failure

References