Can vital signs indicate acute kidney injury in patients with malaria? Results of an observational study in Angola

Abstract

ABSTRACT: The pathogenesis of acute kidney injury (AKI) in malaria is not yet fully understood, however, it is a well-known complication that occurs in 40% of patients with severe P. falciparum disease and can contribute to high mortality rates (around 75% of cases). The present study aimed to analyze whether vital signs can indicate AKI in patients with malaria. The study was a cross-sectional study and quantitative approach. Of the 194 patients admitted, 115(59%) had creatinine values below 1.4 mg/dL, 41%(79) had some kidney damage, 13%(26) with AKI1, 6%(12) AKI2, 5%(10) AKI3 and 16%(31) AKD. Most patients were male 59%(114) and the mean weight was 64.7 kg. The average temperature increased as the kidney condition worsened, where patients AKI1 (36.7 °C), AKI2 (37.2 °C), AKI3 (37.6 °C), and AKD (37.8 °C). The blood pressure was higher in patients with AKI1 (147/97 mmHg), pulse was higher in patients without AKI (104.5 pulsations/minute), the respiratory cycle was slightly higher in patients without AKI, AKI1, AKI2, and AKI3 (with averages above 20.8 breathing cycles/minutes). Mortality increased in renal condition worsened, were patients without AKI was 2%(2/115), AKI1 12%(3/26), AKI2 8%(1/12), AKI3 60%(6/10), and AKD 32%(10/32). We conclude that vital signs could be considered indicators of kidney damage, especially when there is little laboratory diagnostic capacity, and can be an excellent help for health professionals in the assessment and decision-making in the treatment of patients with malaria.

Keywords

• Vital signs
• Acute kidney injury
• Malaria
• Angolans patients