STUDY OF ACUTE RENAL FAILURE IN MALARIA IN SOUTHERN RAJASTHAN

Abstract

BACKGROUND: Wide spectrum of kidney and kidney-related disorders, ranging from urinary abnormalities like proteinuria (< 1gm/24 hour) to kidney failure, can be caused by plasmodium falciparum. Falciparum malaria causes more frequently renal failure. Renal failure incidence by falciparum is variable between 1-4%.2,3. Renal failure is uncommon in vivax malaria. METHODS: It is an observational cross-sectional study of 266 cases of malaria through biochemical and hematological analysis of the blood of patients suffering from malaria infections between Jan 2018 to July 2022. RESULTS: Out of 266 cases of malaria in the age group 14-80 years, acute renal failure was seen in 20 cases (7.5%). Out of 20 renal failure cases, the maximum cases were 15 (75%) caused by plasmodium falciparum then, 3 (15%) cases by plasmodium vivax, and 2(10%) cases by mix (PF & PV). The presenting feature were fever (75%), jaundice (20%), and splenomegaly (20%). The probable contributing factors for renal failure were hyperbilirubinemia 9 (45%), hemolysis 9 (45%) hypotension 1 (5%), and oliguria present in 8(40%). Haemodialysis is required in 7 (35%) patients. Mortality was noted in 5% (1/20) of patients. CONCLUSIONS: Acute renal failure is caused more commonly by plasmodium falciparum than plasmodium vivax malaria. Acute tubular necrosis due to renal ischemia is the dominant pathogenic mechanism. The malarial parasites are commonly associated with jaundice, hemolysis, thrombocytopenia, and hypotension. The prognosis of renal failure is better in P. vivax than in P. falciparum.