• Junejo Abdul Manan
  • Hassan Ali
  • Manohar Lal


Background: Malaria has protean clinical manifestations and acute renal failure (ARF) is one ofits serious complications and could be life threatening. This study was carried out to describe theclinical characteristics and factors associated with adverse out come in patients with malarialacuterenal failure. Materials and Methods : Data of 46 Patients with ARF and smear positive malariawas analyzed further among all cases of ARF presented to us at Nephrology department of JinnahPostgraduate Medical Centre, Karachi from January 2003 to December 2004.Results wereexpressed as mean, standard deviation and range. Results: Among 237 patients with ARF ofdiverse etiology, 46(19.4%) developed ARF due to falciparum malaria. The male to female ratiowas 3.6:1. Oliguria was seen in 76.09% on admission, and 78.26% required dialysis. In additionto ARF, most of the patients had at least one other manifestation of severe malaria. 35(76.06%)patients recovered completely while 11(23.91%) died in early dialysis. Prolonged diseaseduration, severe ARF, cerebral malaria, hyperbilirubinaemia, and disseminated intravascularcoagulopathy (DIC) were poor prognostic factors. Conclusion: Falciparum malaria associatedwith ARF is a life threatening condition, but early presentation and intervention with appropriateanti-malarial and dialysis therapy is associated with improved survival and recovery of renalfunction. Early dialysis treatment in patients with severe falcipaum malaria and signs ofdeteriorating renal function is recommended.Key words: Acute renal failure , malaria, falciparum malaria, haemodialysis .


Trampuz A, Jereb M, Muzlovic L, Prabhu RM. Clinical

review: severe malaria. Critical Care 2003; 7: 315–23.

Nand N, Aggarwal H, Sharma M, Singh M . Systemic

manifestations of malaria. JIACM 2001; 2:189-94.

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

Parkash J, Singh AK, Kumar NS, Saxene RK. Acute renal

failure in plasmodium vivax malaria. J Assoc physicians

India 2003;51:265-7

World Health Organization. Severe falciparum malaria.

Trans R Soc Trop Med Hyg 2000; 94:S1 -S90.

Eiam-Ong S, Sitprija V. Falciparum malaria and the kidney:

a model of inflammation. Am J Kidney Dis 1998; 32:361-75

Boonpucking V, Sitprija V. Renal disease in acute

plasmodium falciparum infection in man. Kidney Int 1979;

: 44-52.

Naqvi R, Ahmad E, Akhtar F, Naqvi A, Rizvi A. Out come

in severe acute renal failure associated with malaria. Nephrol

Dial Transplant 2003; 18:1820 -23

Zewdu W. Acute renal failure in Addis Abeba, Ethiopia: a

prospective study of 136 patients. Ethiop Med J 1994; 32:79-

Parkash J, Gupta A, Kumar O, Rout SB, Malhotra V,

Srivastava PK. Acute renal failure in falciparum malariaincreasing prevalence in some areas of India-a need for

awarness. Nephrol Dial Transplant 1996; 11: 2414-16.

Eiam-Ong S. Current knowledge in falciparum

malaria- induced acute renal failure. J Med Assoc Thai 2002;

suppl: S16-24.

Wilairatana P, Westerlund EK, Aursudkij B, Vannaphan S,

Krudsood S, Viriyavejakul P, et al. Treatment of malarial

acute renal failure by hemodialysis. Am J.Trop.Med.Hyg

; 60: 233-37.

Barsoum RS. Malarial acute renal failure. J Am Soc Nephrol

; 11: 2147-2154.

Sitprija V, Indraprasit S, Pochanugool C, Benyaiati C,

Piyaratn P. Renal failure in malaria. Lancet 1967; 1: 185-88.

Habte B. Acute renal failure due to falciparum malaria.

Renal fail 1990; 12: 15-19.

Trang TT, Phu NH, Vinh H, Hieden TT, Cuong BM, Chau

TT et al. Acute renal failure in patients with severe

falciparum malaria. Clin Infect Dis 1992; 15:874-80

Lalloo DG, Trevett AJ, Korinhona A, Laurenson IF, Mapao

J, Nwololo N et al. Severe and complicated falciparum

malaria in Melanesian adults in Papua New Guinea. Am J

trop Med Hyg 1996; 55: 119-24

Mukherjee AP, White JC, Lau KS. Falciparum malaria

associated with jaundice, renal failure and anaemia. TransR

Soc Trop Med Hyg 1971;65:808-14

Ladhani S, Lowe B, Cole AO, Kowuondo K, Newton CR.

Changes in white blood cells and platelets in children with

falciparum malaria: relationship to disease outcome. Br J


Gerardin P , Rogier C, KA Amadous S, Jouvencel P,

Brousse V, Imbert P. Prognostic value of thrombocytopenia

in African children with falciparum malaria. Am J Trop Med

Hyg 2002; 66: 686-91

Koh K H, Chew P H, Kiyu A. A retrospective study of

malaria infections in an intensive

care unit of general hospital in Malaysia. Singapore Med J

; 45:28-36.