Malarial nephropathy

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Malarial nephropathy
The-incidence-of-malaria-per-1000-population.jpg
SpecialtyNephrology

Malarial nephropathy is kidney failure attributed to malarial infection. Among various complications due to infection, renal-related disorders are often the most life-threatening.[1] Including malaria-induced renal lesions, infection may lead to both tubulointerstitial damage and glomerulonephritis.[2] In addition, malarial acute kidney failure has emerged as a serious problem due to its high mortality rate in non-immune adult patients.[2][3]

Signs and symptoms

In terms of the presentation of Malarial nephropathy we find the following:[1][2][3]

Mechanism

Due to the complex malarial syndrome, there are many pathogenic interactions leading to acute renal failure, such as hypovolemia, intravascular hemolysis and disseminated intravascular coagulation.[1][2][3] Malarial acute renal failure prevents the kidneys from efficiently removing excess fluid, electrolytes and waste material from the blood.[1][2][3][4] The accumulation of these fluids and material will cause adverse consequences for the patient including, electrolyte abnormality and increased urinary protein excretion.[4]

Histologic evidence shows a large combination of pathogenic mechanisms at play—acute tubular necrosis, interstitial nephritis and glomerulonephritis.[1]

Diagnosis

The evaluation of this condition can be done via blood test[5][6]

Treatment

Untreated patients often face a large number of physical complications, but early diagnosis and effective treatment can reduce the high risk of mortality in patients.[1][2][3] A three-pronged approach against infection is regularly needed for successful treatment. antimalarial drug therapy (e.g., artemisinin derivatives), fluid replacement (e.g., oral rehydration therapy), and if needed, renal replacement therapy.[1][2][3]

Epidemiology

Malarial nephropathies are reported in endemic areas, such as Southeast Asia, India, and Sub-Saharan Africa.[1][2][3] The pathogenesis of acute kidney injury in severe malaria is unspecific and multifactorial—it affects fewer than 4.8 percent of cases, but reports a high risk of mortality (15 to 45 percent).[1][2][3]

References

  1. 1.0 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 Barsoum, Rashad S. “Malarial Acute Renal Failure.” J Am Soc Nephrol 11 (2000): 2147-2154.
  2. 2.0 2.1 2.2 2.3 2.4 2.5 2.6 2.7 2.8 Das, B.S. “Renal failure in malaria.” J Vector Borne Dis. 45 (2008): 83-97.
  3. 3.0 3.1 3.2 3.3 3.4 3.5 3.6 3.7 Manan, Junejo Abdul, Hassan Ali, and Manohar Lal. “Acute Renal Failure Associated with Malaria.” J Ayub Med Coll Abbottabad 4 (2006): 47-52.
  4. 4.0 4.1 "Acute kidney failure - Symptoms and causes". Archived from the original on 2019-08-24. Retrieved 2022-06-03.
  5. Elsheikha, Hany M.; Sheashaa, Hussein A. (October 2007). "Epidemiology, pathophysiology, management and outcome of renal dysfunction associated with plasmodia infection". Parasitology Research. 101 (5): 1183–1190. doi:10.1007/s00436-007-0650-4. ISSN 0932-0113. Archived from the original on 2022-08-02. Retrieved 2024-01-09.
  6. da Silva, Geraldo Bezerra; Pinto, José Reginaldo; Barros, Elvino José Guardão; Farias, Geysa Maria Nogueira; Daher, Elizabeth De Francesco (3 August 2017). "Kidney involvement in malaria: an update". Revista do Instituto de Medicina Tropical de São Paulo. 59: e53. doi:10.1590/S1678-9946201759053. ISSN 0036-4665. Archived from the original on 15 January 2024. Retrieved 9 January 2024.