Study of epidemiological profile, clinico-biochemical spectrum and prognosis of malaria induced renal dysfunction in paediatrics age group

Suman Panwar, Rajendra Kumar Soni, Nishat Ahmed


Background: Aim of current study was to assess the epidemiology, clinico-biochemical spectrum and prognosis of acute malaria induced nephropathy in children.

Methods: This was a prospective study conducted in the period from November 2013 to November 2014 in children suffering from acute malaria induced acute kidney injury. Malaria was confirmed by peripheral blood film or Rapid malaria test and detailed clinical evaluation and investigations were carried out to find multi-organ afflictions with special emphasis on renal involvement.

Results: Out of total 200 cases with malaria recorded in our hospital 60 (30%) cases had acute malaria induced acute kidney injury caused by Plasmodium vivax in 45 (75%), Plasmodium falciparum in 3 (5%) and mixed infection in 12 (20%) cases. Thirty percentage of cases had come from Sri Ganganagar district making it the most common geographical region in our study. The sex ratio was 3.6:1. Most common age group was 5-10 year age group contributing to 45% of the cases. Fever and oliguria being the most common presentation and was observed in all the cases followed by vomiting, pain abdomen and hypotension which was present in 33%, 32% and 20% of the cases respectively. Oliguria was present in all the cases in which 24 (40%) cases had urine output <1 ml/kg/hour, 36 (60%) patient had urine output <0.5 ml/kg/hour with G.F.R >25 ml/min/1.73m2 and <25 ml/min/1.73m2 seen in 40 (66%) and 3 (5%) cases respectively. Fifty five patients (91.66%) had S. creatinine between 1.5-3 mg/dl and only 5 patients (8.33%) had serum creatinine >3 mg/dl. 75% cases recovered in <5 days and 4 patients expired, 2 due to respiratory failure and 2 due to MODS and cerebral malaria. expired cases two were died due to respiratory failure, other two were died due to multiorgan failure and cerebral malaria.

Conclusions: The spectrum of renal involvement due to malaria is variable ranging from mild derangement of renal functions to advanced stage of renal dysfunction which needs immediate dialysis. Severe renal involvement was mainly seen with P. falciparum but in our study it is mainly seen with P. vivax infection.


Acute renal failure, Plasmodium vivax, Plasmodium falciparum, Malarial acute kidney injury, Malaria induced acute kidney injury

Full Text:



Elsheikha HM, Sheashaa HA. Epidemiology, Pathophysiology, management and outcome of renal dysfunction associated with plasmodia infection. Parasitol Res. 2007;101:1183-90.

Das BS. Renal failure in malaria. J Vector Borne Dis. 2008;45:83-97.

Trampuz A, Jereb M, Muzlovic I, Prabhu RM. Clinical review: severe malaria. Crit Care. 2003;7:315-23.

Nand N, Aggrawal H, Sharma M, Singh M. Systemic manifestations of malaria. J Indian Acad Clin Med. 2001;2:189-94.

Brewster DR, Greenwood BM. Seasonal variation of pediatric diseases in the Gambia, West Africa. Ann Trop Paediatr. 1993;13:133-46.

Sharma AK, Arora M, Gupta H, Gupta R. Malarial acute renal failure in Rajasthan. J Assoc Physicians India. 1998;46:1001-2.

Mehta KS, Halankar AR, Makwana PD, Torane PP, Satija PS, Shah VB. Severe acute renal failure in malaria. J Postgrad Med. 2001;47:24-6.

Brady HR, Brenner BM, Clarkson MR, Leiberthal W. Acute renal failure. In: Barry M, Brenner, eds. The Kidney. 6th ed. Philadelphia: WB Saunders Co; 2000: 1201.

Mahakur AC, Panda SN, Nanda BK, Bose TK, Satapathy SR, Misra Y. Malarial acute renal failure. J Assoc Physicians India. 1983 Oct;31(10):633-66.

Sheehy TW, Reba RC. Complications of falciparum malaria their treatment. Ann Int Med. 1967;66:807-9.

Nand N, Aggarwal H, Sharma M, Singh M. Systemic manifestation of malaria. J Indian Acad Clin Med. 2001;2:189-94.

Kumar S, Epstein JE, Richie TL. Vaccines agonist asexual stage malaria parasites. Chem Immunol. 2002;80:282-6.

Tripathy R, Parida S, Das L, Mishra DP, Tripathy D, Das MC, et al. Clinical manifestations and predictors of severe malaria in Indian children. Pediatrics. 2007;120:e454-60.

Mehta KS, Halankar AR, Satija PS, Torne PP, Panchal PD, Saha VB, et al. Severe acute renal failure in malaria. South Asian Nephrology Congress and International CME. New Delhi: Scientific Proceedings; 2000: 22.

Kanodia KV, Shah PR, Vanikar AV, Kasat P, Gumber M, Trivedi HL. Malaria induced acute renal failure: a single centre experience. Saudi J Kidney Dis Transplant. 2010;21(6):1088-91.

Stone WJ, Hanchett JE, Knepshield JH. Acute renal insufficiency due to falciparum malaria. Review of 42 cases. Arch Intern Med. 1972;129(4):620-8.

Mishra SK, Mohapatra S, Mohanty S, Patel NC, Mohapatra DN. Acute renal failure in falciparum malaria. J Indian Acad Clin Med. 2002;3(2):141-7.

Sitprija V, Indraprasit S, Pochanugool C, Benyajati C, Piyaratn P. Renal failure in malaria. Lancet. 1967;1(7483):185-8.