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Clinical and Laboratory Features Associated with Acute Kidney Injury in Severe Malaria

Hiren Anghan1, Prayas Sethi1, Manish Soneja1

  • 1Department of Medicine, All India Institute of Medical Sciences, New Delhi, India.

Indian Journal of Critical Care Medicine : Peer-Reviewed, Official Publication of Indian Society of Critical Care Medicine
|November 9, 2018
PubMed
Abstract

Insights

Severe malaria, particularly Plasmodium vivax, frequently causes acute kidney injury (AKI) in India. Factors like tachycardia, jaundice, anemia, and sepsis are linked to AKI and increased mortality in these patients.

Area of Science:

  • Infectious Diseases
  • Nephrology
  • Tropical Medicine

Background:

  • Severe malaria is a significant cause of hospitalization in India.
  • Limited studies have investigated factors contributing to acute kidney injury (AKI) in malaria patients.
  • This study addresses the gap in understanding AKI determinants in severe malaria.

Purpose of the Study:

  • To identify clinical factors associated with the development of acute kidney injury (AKI) in patients with severe malaria.
  • To explore the relationship between specific malaria species and AKI.
  • To determine predictors of mortality in malaria patients with AKI.

Main Methods:

  • A prospective observational study was conducted in a tertiary care center in North India.
  • Adult patients admitted with severe malaria between 2012 and 2014 were included.
  • Data on clinical features, complications, and outcomes were collected and analyzed.

Main Results:

  • Out of 79 severe malaria patients, 36 (45.6%) developed AKI.
  • Plasmodium vivax was identified in 47.2% of patients, with 36% of P. vivax malaria patients experiencing AKI.
  • Tachycardia, direct hyperbilirubinemia, anemia, and sepsis were significantly associated with AKI in P. vivax malaria.
  • Tachycardia, acidosis, cerebral malaria, ARDS/ALI, hypotensive shock, and low GCS predicted higher mortality in AKI patients.

Conclusions:

  • Plasmodium vivax is a notable cause of severe malaria with AKI in the study region.
  • Several clinical features are associated with AKI development and mortality in severe malaria patients.
  • Early identification of these factors is crucial for improving patient outcomes.
Keywords:
Acute kidney injurycritically illsevere malaria

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