Acute Renal Failure in Patients with Severe Falciparum Malaria: Using the WHO 2006 and RIFLE Criteria

Thanachartwet, Vipa; Desakorn, Varunee; Sahassananda, Duangjai; Win, Ko Ko Yazar Kyaw; Supaporn, Thanom

doi:10.1155/2013/841518

Cited by 33 publications

(28 citation statements)

References 24 publications

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“…Higher propensity to contract malaria infection in men has been a consistent observation from this study region [9,20,34,35,38,39]. Male preponderance in malaria population has also been reported from other places in India [44−46] and elsewhere [47,48]. In contrast, female predominance was found in vivax malaria in Papua, Indonesia [36].…”

Section: Baseline Characteristicssupporting

confidence: 86%

Severe vivax malaria: a prospective exploration at a tertiary healthcare centre in Southwestern India

Kumar

Saravu

2017

Pathogens and Global Health

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Plasmodium vivax is recognized to cause severe malaria and mortality. We aimed to determine the proportion of disease severity, the spectrum of complications, underlying non-infectious comorbidities and predictors of severity in monoinfection P. vivax malaria among adults at a tertiary healthcare centre in Southwestern India. A prospective cohort study was conducted among microscopically confirmed monoinfection P. vivax acute malaria patients aged, ≥18 years. Cases with pregnancy and concomitant febrile illnesses including mixed malaria were excluded. Cases were distinguished as either 'severe' or 'non-severe' P. vivax malaria as per the definitions laid by the World Health Organization. Of total 511 acute P. vivax cases studied, 23.9% (122/511) had severe malaria. The proportion of severity did not vary between microscopy alone and additional nPCR proved monoinfection P. vivax subgroups. There was no significant difference (p = 0.296) in the occurrence of non-infectious comorbidities among non-severe (9.0%, 35/389) and severe (12.3%, 15/122) vivax groups. Multiple complications despite early parasite clearance resulted in delayed casualty in two cases, indicating overall case fatality rate of 3/1000 cases. Age >40 years, rising respiratory rate, total bilirubin, serum creatinine and falling hemoglobin were the independent predictors of disease severity in this vivax malaria cohort. Total and direct bilirubin and serum urea had good discriminatory performance for severe vivax malaria. Total bilirubin should be considered as an important prognostic marker while managing P. vivax malaria. Patients with multiple complications must be treated cautiously as there may be delayed deterioration leading to mortality despite parasite clearance.

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Section: Baseline Characteristicssupporting

confidence: 86%

Severe vivax malaria: a prospective exploration at a tertiary healthcare centre in Southwestern India

Kumar

Saravu

2017

Pathogens and Global Health

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“…The low incidence of severe AKI compared to other studies can be explained by our inclusion of the full spectrum of hospitalized malaria patients and the predominance of P.vivax species [12]. The requirement of dialysis was similar to that of Thanachartwet et al [12], although lower than the reported 73–80% by other studies [6], [13], [15]. The 15.2% severe AKI mortality rate was in concordance with some studies, [4], [6] but lower than the range of 26–32% reported by others [10], [12].…”

Section: Discussionmentioning

confidence: 72%

Risk Factors and Outcomes Stratified by Severity of Acute Kidney Injury in Malaria

2014

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Severe acute kidney injury (AKI) is known to have prognostic value for in-hospital outcomes in malaria. However, little is known about the association of AKI of lesser severity with malarial risk factors and outcomes – and such a gap is becoming increasingly relevant with the upsurge in the incidence of AKI due to Plasmodium falciparum malaria and Plasmodium vivax malaria over the last decade. We aimed to identify risk factors of AKI in malaria and assessed in-hospital outcomes stratified by severity of AKI. We performed an observational study of 1,191 hospitalized malaria patients enrolled between 2007 and 2011 in a tertiary care academic center in India. Patients were categorized based on peak serum creatinine into one of three groups: no AKI (<1.6 mg/dL), mild AKI (1.6–3.0 mg/dL), and severe AKI (>3 mg/dL). Plasmodium vivax was the predominant species (61.41%), followed by Plasmodium falciparum (36.41%) and mixed infections with both the species (2.18%). Mild and severe AKI were detected in 12% and 5.6% of patients, respectively. Mild AKI due to Plasmodium vivax (49%) and Plasmodium falciparum (48.5%) was distributed relatively equally within the sample population; however, cases of severe AKI due to Plasmodium falciparum (80%) and Plasmodium vivax (13%) was significantly different (P<0.001). On history and physical examination, risk factors for AKI were age, absence of fever, higher heart rate, lower diastolic blood pressure, icterus, and hepatomegaly. The only laboratory parameter associated with risk of AKI on multivariate analysis was direct bilirubin. Patients with mild and severe AKI had greater organ complications, supportive requirements, longer duration of hospital stay and in-hospital mortality in a dose-dependent relationship, than patients with no AKI. Mild AKI is associated with significant (P<0.05) morbidity compared to no AKI, and future studies should assess strategies for early diagnosis of AKI and prevent AKI progression.

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“…Kidney injury, acute or chronic, is one of the common differential diagnosis of malaria manifesting as syndrome. The diverse presentations and aetiological mechanisms of AKI orbit around the properties of pRBC's on microcirculation, hypovolaemia, metabolic derangements or host immunologic responses to infection [175][176][177]. These major pathogenic features are originated by the Plasmodium infection but may not be limited by the annihilation of the infection.…”

Section: Malarial Acute Kidney Injury (Aki) and Oxidative Stressmentioning

confidence: 99%

Malarial Pathophysiology and Phytochemical Interventions: A Current Discourse on Oxidative Stress Anti-Disease Phytotherapeutics

Mavondo¹,

Mkhwanazi²,

Mavondo³

et al. 2019

Malaria

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Malarial systemic pathophysiology refers to physiological changes or abnormalities that are experienced by individuals infected with the Plasmodium parasite not be presenting in the absence of active, chronic or previous infection. The pathologies are derived, in part, from OS induced insults whose mediators are readily available in malaria. The malaria disease is equivalent to the pathophysiology as shown by the abnormal syndromic expressions ranging from ailments that affect homeostatic mechanisms and processes to tissues and organ specific damages and derangements. Phytotherapeutic remedies refer to the natural phytochemicals or plant medicinal compounds and their derivatives with known antiparasitic and antimalarial disease effects in both experimental and clinical situations. The chapter explores how Plasmodium infection generates or cause to be generated oxidative stress, how oxidative stress drives systemic disease process and how phytotherapeutics treatment (artemisinins) and administration (asiatic acid) in malaria resolves the various pathologies as a current situational analysis.

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Acute Renal Failure in Patients with Severe Falciparum Malaria: Using the WHO 2006 and RIFLE Criteria

Cited by 33 publications

References 24 publications

Severe vivax malaria: a prospective exploration at a tertiary healthcare centre in Southwestern India

Severe vivax malaria: a prospective exploration at a tertiary healthcare centre in Southwestern India

Risk Factors and Outcomes Stratified by Severity of Acute Kidney Injury in Malaria

Malarial Pathophysiology and Phytochemical Interventions: A Current Discourse on Oxidative Stress Anti-Disease Phytotherapeutics

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