Acute Acute Renal Failure and Hepatic Disfunction in Malaria

Abstract

The clinical presentations of severe and complicated malaria vary. The prognosis is poor when associatedwith cerebral malaria and acute renal failure. Clinical profile, biochemical parameters and outcome werestudied in 46 adult patients of malaria admitted in a tertiary care hospital between April 2002 to April2003. The age of the patients ranged from 15 to 60 years. Majority (n=30) of the patients were in age groupof 15 to 34 years. 67% of the patients were from terai belt. Mean duration of febrile illness was 10 days atthe time of presentation. 39% (n=18) patients had hepatic dysfunction and 22% (n=10) had acute renalfailure (ARF) according to WHO criteria. All patients with ARF were oligo-anuric and required dialysissupport. Four patients died of which three were patients with ARF and hepatic dysfunction. Althoughmalaria still remains a major health problem, malarial renal disease has not been formally reported previouslyfrom Nepal. Early initiation of antimalarial therapy, close observation for organ failure and early initiationof dialysis in ARF is instrumental in the recovery of the patient.Key Words: Malaria, Organ Failure.