Clinical Profile and Treatment Outcomes of Patients with Malaria Complicated by Acute Kidney Injury.
Journal
Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia
ISSN: 1319-2442
Titre abrégé: Saudi J Kidney Dis Transpl
Pays: Saudi Arabia
ID NLM: 9436968
Informations de publication
Date de publication:
01 Mar 2023
01 Mar 2023
Historique:
medline:
26
12
2023
pubmed:
26
12
2023
entrez:
26
12
2023
Statut:
ppublish
Résumé
As Odisha is an endemic region for malaria with many acute kidney injury (AKI) cases, this study evaluated the clinical profile and treatment outcomes of patients with malaria complicated by AKI. This prospective observational study was conducted between December 2015 and September 2017. Detailed histories and clinical examinations were recorded. On admission, tests for routine hematology, plasma glucose, liver function, renal function, serum electrolytes, thick smears, thin smears, and malarial parasites were performed. Of the 958 AKI malarial patients admitted, 202 (82.6 % males) were included in the study, with a mean age of 38.37 years. In total, 86.14%, 3.46%, and 10.39% of patients had Plasmodium falciparum, Plasmodium vivax, and mixed malaria, respectively. Headache and decreased urination (83.66% each) were the most common symptoms after fever (100%). Anuria and oliguria were reported in 5.95% and 67.82% of patients, respectively, whereas 26.23% reported a urine output of >400 mL/24 h. All patients had raised serum creatinine and urea levels, and >60% had anemia, proteinuria, and/or hyponatremia. Multiple organ dysfunction syndrome was observed in 62.87% of patients. Acute tubular necrosis was seen in 60% of renal biopsy specimens (n = 15). Of the 75.75% of patients requiring dialysis, 82.12% and 17.88% of patients required hemodialysis and peritoneal dialysis, respectively, during which 11 patients died. AKI, a serious complication of P. falciparum or P. vivax malaria, is a life-threatening condition. Fever, anemia, oligo/anuria, hepatic involvement, cerebral malaria, high serum creatinine and urea, and disseminated intravascular coagulation were the main predictors of mortality in our study.
Identifiants
pubmed: 38146720
doi: 10.4103/1319-2442.391889
pii: 00936703-202334020-00003
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
117-124Informations de copyright
Copyright © 2023 Copyright: © 2023 Saudi Journal of Kidney Diseases and Transplantation.
Références
World Health Organization. World Malaria Report. World Health Organization Press; 2012.
Saravu K, Rishikesh K, Parikh CR. Risk factors and outcomes stratified by severity of acute kidney injury in malaria. PLoS One 2014;9:e90419.
Prakash J, Singh AK, Kumar NS, Saxena RK. Acute renal failure in Plasmodium vivax malaria. J Assoc Physicians India 2003;51:265-7.
Kochar DK, Kochar SK, Agrawal RP, et al. The changing spectrum of severe falciparum malaria: A clinical study from Bikaner (Northwest India). J Vector Borne Dis 2006;43:104-8.
Koopmans LC, van Wolfswinkel ME, Hesselink DA, et al. Acute kidney injury in imported Plasmodium falciparum malaria. Malar J 2015;14:523.
Panda SK, Das MC, Meher LK, Rathod PK. Risk factors for acute renal failure in severe falciparum malaria. Indian J Nephrol 2003;13:55-8.
Silva GB Junior. , Pinto JR, Barros EJ, Farias GM, Daher EF. Kidney involvement in malaria: An update. Rev Inst Med Trop Sao Paulo 2017;59:e53.
Das BS. Renal failure in malaria. J Vector Borne Dis 2008;45:83-97.
Barsoum RS. Malarial acute renal failure. J Am Soc Nephrol 2000;11:2147-54.
Krishnan A, Karnad DR. Severe falciparum malaria: An important cause of multiple organ failure in Indian intensive care unit patients. Crit Care Med 2003;31:2278-84.
Directorate of National Vector Bone Disease Control Programme Odisha 2016; 2017.
Kumar A, Valecha N, Jain T, Dash AP. Burden of malaria in India: Retrospective and prospective view. Am J Trop Med Hyg 2007;77:69-78.
Sharma AK, Arora M, Gupta H, Gupta R. Malarial acute renal failure in Rajasthan. J Assoc Physician India 1998;46:1001-2.
Prakash J, Singh TB, Ghosh B, et al. Changing epidemiology of community-acquired acute kidney injury in developing countries: Analysis of 2405 cases in 26 years from Eastern India. Clin Kidney J 2013;6:150-5.
Chugh KS. Renal disease in India. Am J Kidney Dis 1998;31:Ivii-Iix.
Shukla VS, Singh RG, Rathore SS, Usha. Outcome of malaria-associated acute kidney injury: A prospective study from a single center. Ren Fail 2013;35:801-5.
Naqvi R, Ahmad E, Akhtar F, Naqvi A, Rizvi A. Outcome in severe acute renal failure associated with malaria. Nephrol Dial Transplant 2003;18:1820-3.
Khan R, Quaiser S, Haque SF. Malarial acute kidney injury: Prognostic markers. Ann Trop Med Public Health 2013;6:280-4.
Kute VB, Trivedi HL, Vanikar AV, et al. Plasmodium vivax malaria-associated acute kidney injury, India, 2010-2011. Emerg Infect Dis 2012;18:842-5.
Prakash J, Gupta A, Kumar O, Rout SB, Malhotra V, Srivastava PK. Acute renal failure in falciparum malaria – Increasing prevalence in some areas of India – A need for awareness. Nephrol Dial Transplant 1996;11:2414-6.
Berendt AR. Sequestration and its discontents: Infected erythrocyte-endothelial cell interactions in Plasmodium falciparum malaria. Res Immunol 1993;144:740-5.
Muhamedhussein MS, Ghosh S, Khanbhai K, Maganga E, Nagri Z, Manji M. Prevalence and factors associated with acute kidney injury among malaria patients in Dar es Salaam: A cross-sectional study. Malar Res Treat 2019;2019:4396108.
Helbok R, Dent W, Nacher M, et al. The use of the multi-organ-dysfunction score to discriminate different levels of severity in severe and complicated Plasmodium falciparum malaria. Am J Trop Med Hyg 2005;72:150-4.
Kute VB, Shah PR, Munjappa BC, et al. Outcome and prognostic factors of malaria- associated acute kidney injury requiring Hemodialysis: A single center experience. Indian J Nephrol 2012;22:33-8.
Abdul Manan J, Ali H, Lal M. Acute renal failure associated with malaria. J Ayub Med Coll Abbottabad 2006;18:47-52.
Nguansangiam S, Day NP, Hien TT, et al. A quantitative ultrastructural study of renal pathology in fatal Plasmodium falciparum malaria. Trop Med Int Health 2007;12:1037-50.
Kimmatkar P, Jhorawat R, Gandhi K, et al. Acute kidney injury in patients with Plasmodium vivax malaria: Clinicohistopatho- logical profile. Saudi J Health Sci 2016;5:138-41.
Wilairatana P, Westerlund EK, Aursudkij B, et al. Treatment of malarial acute renal failure by Hemodialysis. Am J Trop Med Hyg 1999;60:233-7.
Mishra SK, Mahanta KC. Peritoneal dialysis in patients with malaria and acute kidney injury. Perit Dial Int 2012;32:656-9.