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Acute renal failure in Plasmodium vivax malaria
Summary
Plasmodium vivax malaria can cause acute renal failure (ARF), though less common than with P. falciparum. The study found ARF in vivax malaria cases had a favorable prognosis, with renal ischemia as a key factor.
Area of Science:
- Infectious Diseases
- Nephrology
- Tropical Medicine
Background:
- Acute renal failure (ARF) is a serious complication of malaria.
- Plasmodium falciparum malaria is more frequently associated with ARF than Plasmodium vivax malaria.
Purpose of the Study:
- To investigate the incidence, clinical features, and outcomes of acute renal failure (ARF) specifically caused by Plasmodium vivax malaria.
- To compare ARF in P. vivax malaria with that of P. falciparum malaria.
Main Methods:
- Retrospective analysis of smear-positive Plasmodium vivax patients diagnosed with acute renal failure between January 1995 and December 2000.
- Data collected included patient demographics, presenting symptoms, contributing factors to ARF, treatment interventions, and mortality.
Main Results:
- Out of 577 ARF cases, 19 (3.2%) were attributed to P. vivax malaria, compared to 74 cases from P. falciparum.
- Common clinical features included fever (100%), jaundice (36.8%), hypotension (42%), and encephalopathy (57.9%).
- Key contributors to ARF were heavy parasitemia (57.9%), hypotension (31.5%), and hemolysis (42%). Mortality was 15.7%.
Conclusions:
- Plasmodium vivax malaria can lead to acute renal failure, although it is less frequent than in P. falciparum infections.
- Renal ischemia leading to acute tubular necrosis is the primary pathogenic mechanism.
- The prognosis for acute renal failure in P. vivax malaria is generally favorable.