Origin of proteinuria in human malaria

The prevalence and pathogenesis of renal involvement was investigated in 74 patients with malarial infections. A rise in proteinuria of 150 to 5,000 mg per day was seen in 12 out of 27 patients with Plasmodium falciparum infections. SDS-polyacrylamide gel electrophoresis revealed either an increase in albumin and high molecular weight proteins alone or an increase in low and high molecular weight proteins. Serum creatinine and urea were increased in 5 patients. In P. vivax infections, 8 out of 46 patients developed a proteinuria level of up to 462 mg per day. Low and, to a lesser degree, high molecular weight proteins were increased. In one patient with quartan malaria infection, proteinuria rose as far as 432 mg per day. There was a correlation between the appearance of proteinuria and fever; however, there was no correlation between the amount of proteinuria and the height of fever. It is therefore unlikely that a rise in temperature is the only cause of proteinuria in malarial infections. The electrophoretic analyses of proteinuria indicate that in malarial infections, glomerular as well as tubular lesions may cause reversible proteinuria.