Study of renal complications of malaria

Background: Plasmodium falciparum malaria is one of the major health problems in many tropical countries including India and due to increase in the drug resistance in India the incidence of complicated malaria has increased. Objectives: To study the renal complications of malaria. Materials and methods: 50 malaria positive cases with clinical renal disease were prospectively observed clinically and by laboratory investigations till the discharge. Results: Among the 50 malaria positive cases 41 (82 %) patients had p. falciparum infection, 4 (8%) had p. vivax and 5 (10%) had mixed infections. P. falciparum and mixed infection found to be responsible for ARF in 25 (89.28%), 3 (10.70%) respectively. Volume depletion was found to be the prominent cause (75%) of ARF, hyperbilirubinemia was noted in 64.28% of patients. Urinary abnormalities were noted in 24 (48%) cases, proteinuria in 20(40%), microscopic haematuria in 20 (40%), granular casts in 7 (14%). In the present study electrolyte abnormalities were noted in 46 (92%) of the patients. The overall mortality in the present study was 5 (10%). The cause of death was multi-factorial. MODS were the commonest cause of death. Conclusion: Renal complications were seen as the commonest complication of malaria. Early diagnosis, treatment specially the fluid management reduces the overall mortality