Plasmodium Falciparum Malaria

Background: Plasmodium falciparum malaria is one of the major health problems in many tropical countries including India and due to increase in the drug resistance in India the incidence of complicated malaria has increased. Objectives: To study the renal complications of malaria. Methods: 50 malaria positive cases with clinical renal disease were prospectively observed clinically and by laboratory investigations till the discharge. Results: Among the 50 malaria positive cases 41(82 %) patients had pl.falciparum infection ,4(8%) had p.vivax and 5(10%) had mixed infections. P.falciparum and mixed infection found to be responsible for ARF in 25 (89.28%), 3(10.70%) respectively. Volume depletion was found to be the prominent cause( 75%) of ARF,

Exclusion Criteria

1. Known case of chronic systemic illness involving the CNS, renal, haematological, respiratory and hepatobiliary systems.

2. Patients with history of alcoholism and those taking hepatotoxic drugs .

3. Patients with altered renal echo texture on ultrasound abdomen .

Detailed history, clinical examination and treatment received were noted from malaria positive cases, which were confirmed by demonstration of malarial parasite by the peripheral smear or by HRP2 antigen. Other laboratory investigations done were complete haemogram, urine examination for albumin and microscopy- red cells, WBC’s casts, crystals and sugar, blood suagr , blood urea ,serum creatinine,serum electrolytes, prothrombin time, APTT,liver function tests.Arterial blood gas analysis , X-ray chest, lumbar puncture, CT brain, blood and urine cultures were done if required. Haematological and bio-chemical investigations were done at the time of diagnosis and at the time of remission of symptoms or disappearance of parasitemia. As per W.H.O. Guidelines renal failure was defined as urine output of (-- removed HTML --)