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Renal function in acute malaria in children
Insights
Acute malaria in children can cause temporary renal impairment, particularly with Plasmodium falciparum infections. Most cases of decreased kidney function in children with malaria resolved over time.
Area of Science:
- Pediatric Nephrology
- Infectious Diseases
- Tropical Medicine
Background:
- Acute malaria is a significant global health issue affecting children.
- Renal impairment is a known complication of severe malaria.
- The specific impact of Plasmodium species on renal function in children requires further elucidation.
Purpose of the Study:
- To assess renal function in children with acute malaria.
- To determine the association between Plasmodium species and the incidence of renal impairment.
- To evaluate the reversibility of malaria-associated renal impairment.
Main Methods:
- Renal function tests, including endogenous creatinine clearance, were performed on 75 children with smear-positive acute malaria.
- A control group of 10 healthy children was included for comparison.
- Data analysis focused on correlating Plasmodium species with the severity of renal impairment.
Main Results:
- Renal impairment (creatinine clearance < 65 ml/min/m2) was observed in 36 of 75 malaria-affected children.
- Plasmodium falciparum was associated with a higher incidence (66%) and greater reduction in creatinine clearance compared to Plasmodium vivax (30%).
- Follow-up data from 14 patients indicated a return to normal renal function.
Conclusions:
- Acute malaria can lead to reversible renal impairment in children.
- Plasmodium falciparum infections pose a greater risk for developing renal dysfunction.
- Prompt diagnosis and management of malaria are crucial for preventing long-term renal complications.
Abstract:
Tests for renal function were performed in 75 smear positive children with acute malaria together with 10 control children. Plasmodium vivax and Plasmodium falciparum accounted for 52 and 46 per cent cases, respectively. Renal impairment in the form of decreased endogenous creatine clearance (less than 65 ml/min/m2) was noted in 36 of the 75 children with malaria. Plasmodium falciparum was responsible for 66 per cent and P. vivax accounted for 30 per cent cases of renal impairment. Plasmodium falciparum parasitaemia produced significantly greater reduction in endogenous creatine clearance (r = 0.198). Fourteen of 36 patients with decreased endogenous creatine clearance who attended for follow-up showed that their creatinine clearance had returned back to normal.