Acute renal failure in Plasmodium vivax malaria
Prakash, J.; Singh, A.K.; Kumar, N.S.; Saxena, R.K.
Journal of the Association of Physicians of India 51: 265-267
2003
ISSN/ISBN: 0004-5772 PMID: 12839348 Document Number: 250723
To analyze incidence, clinical feature and outcome of acute renal failure due to Plasmodium vivax malaria. This is retrospective analysis of smear positive Plasmodium vivax patients with acute renal failure between Jan 1995 to Dec 2000. Out of 577 cases of ARF, 93 [falciparum 74 (79.61%); vivax 19 (20.4%)] were related to complicated malaria. 3.2% (19/577) patients, 16 males and three females with age range 17-72, mean 43.3 +/- 13.4 years were due to vivax malaria. Thirteen had only vivax and six had mixed falciparum and vivax infection. The presenting features were fever (100%), jaundice (36.8%), hypotension--eight (42%), encephalopathy--11 (57.9%), sepsis--five (26.3%) and DIC--four (21%). The probable contributory factors for ARF were heavy parasitemia--11 (57.9%), hypotension--six (31.5%), hyperbilirubinemia--seven (36.8%), hemolysis--eight (42%) and DIC--four (21%). Oliguria was present in 47.3%, 13 (68.4%) patients required dialysis. Mortality was noted in 15.7% (3/19) patients. P. vivax malaria can cause ARF, which occurs more commonly in P. falciparum malaria. Renal ischemia is the dominant pathogenic mechanism that results in acute tubular necrosis. The prognosis of ARF in P. vivax malaria is favorable.