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

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 25 ml/min/1.73m2 and 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.