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Malaria associated acute renal failure--experience from Rourkela, eastern India
Saroj K Mishra1, Kishore C Mahanta, Sanjib Mohanty
1Ispat General Hospital, Internal Medicine, Rourkela.
Journal of the Indian Medical Association
|June 26, 2009
Summary
Acute renal failure is a serious complication of falciparum malaria, particularly in adults. This study highlights its association with increased mortality, especially when combined with jaundice.
Area of Science:
- Tropical Medicine
- Nephrology
- Infectious Diseases
Background:
- Acute renal failure (ARF) is a critical complication of falciparum malaria, significantly increasing morbidity and mortality, especially in adults.
- While ARF in malaria is well-documented globally, data from the Indian subcontinent, particularly eastern India, remains scarce.
- Malaria-associated ARF can occur independently or alongside other severe complications, impacting patient outcomes.
Purpose of the Study:
- To analyze the clinical presentation of malaria patients with a focus on ARF.
- To compare the characteristics and outcomes of malaria patients with and without renal failure.
- To investigate the impact of co-existing complications, such as jaundice, on mortality in malaria patients with ARF.
Main Methods:
- A hospital-based retrospective study analyzing 718 malaria patients admitted in 2001.
- Patients were stratified based on serum creatinine levels (>3 mg/dl indicating ARF).
- Clinical data, presenting complaints, co-morbidities, and outcomes were compared between groups.
Main Results:
- 11.8% of malaria patients (84 out of 718) presented with ARF (serum creatinine >3 mg/dl).
- Patients with ARF had a higher incidence of complications like jaundice (77% vs. 19%) and cerebral malaria (59% vs. 11%).
- Mortality was significantly higher in patients with ARF (p < 0.001), and the combination of ARF and jaundice showed an adverse prognostic impact.
Conclusions:
- Falciparum malaria poses a significant risk for ARF in adults, associated with severe complications and high mortality.
- The co-occurrence of ARF and jaundice in malaria patients is a critical factor contributing to increased mortality.
- Further research is needed to understand the mechanisms behind these trends and develop effective management strategies.
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