ACUTE RENAL FAILURE ASSOCIATED WITH MALARIA
AbstractBackground: 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 .
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