Predictors and Clinical Outcomes of Acute Renal Failure in Patients with Plasmodium falciparum Malaria: A Prospective Cohort Study
Clinical Outcomes of Acute Renal Failure in Patients with Plasmodium falciparum Malaria
DOI:
https://doi.org/10.54393/pjhs.v7i10.4130Keywords:
Plasmodium Falciparum, Acute Renal Failure, Complications of Malaria, KDIGO 2012 CriteriaAbstract
ARF is considered a serious complication of Plasmodium falciparum malaria and a major indicator of morbidity and mortality. Currently, there are no prospective studies from Pakistan investigating the prevalence and risk factors of ARF. Objectives: To ascertain the prevalence of ARF in adults suffering from Plasmodium falciparum malaria and to determine its predictors and clinical outcomes. Methods: A prospective cohort study was undertaken in the Department of Nephrology, Jinnah Postgraduate Medical Centre (JPMC), Karachi. 230 patients, aged between 18 and 60 years, suffering from microscopically confirmed P. falciparum malaria, constituted the study population. ARF was defined using KDIGO 2012 criteria. The renal function was assessed upon admission and on the second and seventh day of admission. The measured outcomes included the requirement for RRT, in-hospital mortality, length of hospital stay, renal recovery, and CKD. The statistical analyses were done with the help of SPSS version 26. Results: Prevalence of ARF was 18.3%. The prevalence of ARF requiring hemodialysis and exhibiting KDIGO stage 3 kidney dysfunction accounted for 52.4%. Higher in-hospital mortality was observed in patients with ARF as compared to patients without ARF. While amongst survivors, most showed renal recovery, some developed CKD. Conclusions: 18.3% of the studied adults admitted with P. falciparum malaria developed ARF. Mortality rate was significantly higher in patients with ARF, by almost ten times, and at a higher risk of developing CKD. Some preventable causes contributing to ARF are cardiovascular disorders, metabolic disorders, and delayed presentation in hospitals.
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