A Study of Renal Manifestation of Malaria in Children

Background: Malaria is a severe disease of worldwide importance as it afflicts more than ninety nations and territories in the tropical and subtropical regions. The renal manifestation in malaria varies from mild proteinuria to severe renal failure. Aims and Objectives: To evaluate the renal manifestations in children with Malaria. Material and Method: This observational study evaluated 50 children aged less than18 years admitted at National Institute Of Medical Science and Research, Jaipur, Rajasthan from January 2019 to June 2020 having malaria. A detailed clinical history, examination and relevant laboratory investigations were recorded on day of presentation. Results: Plasmodium vivax malaria was the predominant form of malaria (50 %). All patients were febrile at admission. The other common presenting complaints were vomiting (28 %) and headache (22 %). Commonest clinical finding were splenomegaly (55 %), pallor (53 %) and hepatomegaly (28 %). Icterus was seen in only 6 % of case. Anemia was present in 44 % of patients, only 4 % of cases had severe anemia. Thrombocytopenia was most common (72 %) hematological abnormality. Severe thrombocytopenia was seen in 17 % of cases. Hematuria was presenting 6 % of cases. Proteinuria was documented in 44 % of case, and it was common with falciparum and mixed malaria than vivax infection. Elevated urine sodium excretion was seen 50 % of cases. Mean urine sodium was high with falciparum infection. Hyponatremia was seen in 64 % of cases. It was common with falciparum and mixed infection. Mean sodium decreases as severity of infection increases. Blood urea and serum creatinine were significantly high in malaria cases. Falciparum cases had higher levels of serum creatinine than vivax and mixed malaria infection. Low glomerular filtration rate was seen 52 % of cases. Conclusion: The evaluation of renal functions in malaria is important as renal involvement is not uncommon and can cause severe morbidity and increase mortality.