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Digital Home-Monitoring of Patients after Kidney Transplantation: The MACCS Platform

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Malarial nephropathy in a tertiary care setup--an observational study.

S K Sharma¹, D N Manandhar, B Khanal

¹Department of Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal. drsanjib@yahoo.com

Nepal Medical College Journal : NMCJ

|February 28, 2012

Summary

Falciparum malaria in Nepal frequently leads to severe outcomes like acute renal failure and cerebral malaria. Early detection and management of renal and hepatic dysfunction are crucial for improving patient survival rates.

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Area of Science:

Tropical Medicine
Infectious Diseases
Nephrology

Background:

Malaria is a significant health concern in Nepal, with Plasmodium falciparum posing a threat.
Severe falciparum malaria is associated with poor prognoses, including acute renal failure (ARF), hepatopathy, and cerebral malaria.

Purpose of the Study:

To investigate the clinical profiles, biochemical parameters, and outcomes of falciparum malaria patients.
To assess the prevalence and impact of renal and hepatic dysfunction in falciparum malaria.

Main Methods:

A study of 25 falciparum malaria patients admitted to BP Koirala Institute of Health Sciences.
Diagnosis confirmed using optimal test, peripheral blood smear (PBS), or Quantitative Buffy Coat (QBC) methods.
Clinical data, biochemical parameters (serum creatinine, total bilirubin), and outcomes were analyzed.

Main Results:

60% of patients exhibited renal dysfunction, with 10 cases of ARF; 5 were oliguric/anuric.
Hepatic dysfunction was present in a significant proportion, indicated by elevated total bilirubin (>2.5 mg/dl in 77%).
Patients with renal and/or hepatic dysfunction showed increased morbidity and mortality; 6 patients died, 5 within 48 hours.

Conclusions:

Renal and hepatic dysfunction are common complications of falciparum malaria in Nepal, significantly increasing mortality risk.
Prompt recognition and management of these complications, including renal replacement therapy (RRT), are vital for patient outcomes.
Further research into preventative strategies and optimized treatment protocols for severe falciparum malaria is warranted.