| Abstract |
Introduction : Malaria poses a great Public Health menace in India especially in the Gangetic Plains of Uttarakhand, Uttar Pradesh and Bihar, which is now endemic for malaria. The present study reports the serious complications of malaria, like malarial nephropathy. Material and Methods : Three hundred sixty patients with acute febrile illness were subjected to various tests of malaria, Routine hematological, biochemical tests and urine examination were performed. The data of their mode of presentation, management and outcome was analyzed. Results : Two hundred forty one cases out of three hundred and sixty were positive for malaria and of these positive cases of malaria, 32 patients (13.2%) revealed renal involvement. Their age ranged from 18 to 65 years (mean + SD = 45.8 + 6.2 years) with male to female ratio being 2.2:1. Plasmodium falciparum alone (50%) or mixed infection with Plasmodium vivax (31.2%) were the causative organism. Oliguria and/or anuria (62.5%) was the commonest mode of presentation. All of them were managed with appropriate antimalarial drugs, fluid and electrolyte replacement and other supportive therapy. Hemodialysis was performed in 10 cases and 8 of them had full recovery. Seven patients(21.8%) expired within 48-72 hours. Multi organ-failure and sepsis were the main causes of death. Conclusion: Our study shows that falciparum malaria is an important cause of acute renal failure. Advanced age, oliguria, anuria, hypovolumia, electrolyte imbalance and late referrals were the main bad prognostic factors. So early intervention is required for the favourable outcomes in these cases.
KEYWORDS: Acute renal failure, Falciparum malaria, Nephropathy, Hypovolumia
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