Acute Acute Renal Failure and Hepatic Disfunction in Malaria

Abstract

The clinical presentations of severe and complicated malaria vary. The prognosis is poor when associated with cerebral malaria and acute renal failure. Clinical profile, biochemical parameters and outcome were studied in 46 adult patients of malaria admitted in a tertiary care hospital between April 2002 to April 2003. The age of the patients ranged from 15 to 60 years. Majority (n=30) of the patients were in age group of 15 to 34 years. 67% of the patients were from terai belt. Mean duration of febrile illness was 10 days at the time of presentation. 39% (n=18) patients had hepatic dysfunction and 22% (n=10) had acute renal failure (ARF) according to WHO criteria. All patients with ARF were oligo-anuric and required dialysis support. Four patients died of which three were patients with ARF and hepatic dysfunction. Although malaria still remains a major health problem, malarial renal disease has not been formally reported previously from Nepal. Early initiation of antimalarial therapy, close observation for organ failure and early initiation of dialysis in ARF is instrumental in the recovery of the patient. Key Words: Malaria, Organ Failure.