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Severe acute renal failure in malaria
K S Mehta1, A R Halankar, P D Makwana
1Department of Nephrology, B.Y.L. Nair Hospital and T.N. Medical College, Mumbai, India. kemneph@vsnl.com
Journal of Postgraduate Medicine
|October 9, 2001
Summary
Acute renal failure (ARF) in malaria is rising. Plasmodium falciparum malaria, severe ARF, DIC, and ARDS are poor prognostic indicators, with resistance to common antimalarials noted.
Area of Science:
- Infectious Diseases
- Nephrology
- Tropical Medicine
Background:
- Rising incidence and severity of acute renal failure (ARF) in malaria cases.
- Malaria-associated ARF poses a significant clinical challenge.
Purpose of the Study:
- To investigate the incidence, severity, and outcomes of acute renal failure in malaria patients.
- To identify prognostic factors and treatment responses in malaria with ARF.
Main Methods:
- Retrospective analysis of one year of data from a tertiary medical center.
- Evaluation of patients with smear-positive malaria and ARF.
- Statistical analysis using mean, range, and standard deviation.
Main Results:
- 24 out of 402 malaria patients developed ARF, predominantly in the 21-40 age group.
- Plasmodium falciparum malaria was associated with severe ARF, with 92% requiring dialysis.
- Poor prognostic factors included severe ARF, disseminated intravascular coagulation (DIC), and acute respiratory distress syndrome (ARDS).
Conclusions:
- Plasmodium falciparum malaria, severe ARF, DIC, and ARDS are indicators of poor prognosis.
- Significant resistance to chloroquine and artesunate was observed, necessitating quinine treatment.
- Prompt recognition and management of ARF in malaria are crucial for patient outcomes.