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Factors associated with acute renal failure in adults with severe falciparum malaria

Ko Ko Yazar Kyaw Win1, Vipa Thanachartwet, Yupaporn Wattanagoon

  • 1Department of Clinical Tropical Medicine, Mahidol University, Bangkok, Thailand.

The Southeast Asian Journal of Tropical Medicine and Public Health
|February 26, 2013
PubMed

Insights

Severe falciparum malaria frequently causes acute renal failure (MARF). Advanced age, hospital referral, high bilirubin, inotropic drug use, and hospital-acquired infections are key factors associated with MARF.

Area of Science:

  • Infectious Diseases
  • Nephrology
  • Clinical Medicine

Background:

  • Severe falciparum malaria is a significant global health concern.
  • Malarial acute renal failure (MARF) is a serious complication with high morbidity and mortality.
  • Understanding factors associated with MARF is crucial for timely intervention.

Purpose of the Study:

  • To identify clinical and demographic factors associated with malarial acute renal failure (MARF) in patients with severe falciparum malaria.
  • To inform clinical awareness and management strategies for preventing MARF.

Main Methods:

  • Retrospective study of 262 adult patients hospitalized with severe falciparum malaria in Thailand (2004-2008).
  • Analysis of medical records to identify incidence and factors associated with MARF.
  • Logistic regression analysis was used to determine independent predictors of MARF.

Main Results:

  • The incidence of MARF was 44%, with most cases present on admission.
  • MARF patients exhibited higher complication rates, longer hospital stays, and increased fatality.
  • Factors associated with MARF included advanced age, hospital referral, elevated total bilirubin, inotropic drug requirement, and hospital-acquired infections.

Conclusions:

  • Advanced age, referral status, hyperbilirubinemia, need for inotropic support, and hospital-acquired infections are significant risk factors for MARF.
  • Clinicians must be vigilant for these factors in patients with severe falciparum malaria to mitigate MARF risk.
  • Early recognition and management of these associated factors can potentially improve outcomes for patients with severe malaria.

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