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Renal involvement in Gambian children with cerebral or mild malaria
Author(s) -
Weber Martin W.,
Zimmermann Ulrich,
Hensbroek Michael Boele,
Frenkel Jost,
Palmer Ayo,
Ehrich Jochen H. H.,
Greenwood Brian M.
Publication year - 1999
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1046/j.1365-3156.1999.00409.x
Subject(s) - malaria , cerebral malaria , medicine , proteinuria , renal function , creatinine , albuminuria , excretion , kidney , gastroenterology , immunology , pediatrics , plasmodium falciparum
Summary Kidney function was studied in 80 Gambian children with cerebral malaria, 73 children with mild malaria, and in 19 children with other febrile illnesses. Serum creatinine was measured, and the excretion in urine of immunoglobulin G, transferrin, albumin and alpha 1 microglobulin was determined. Twenty‐five percent of children with cerebral malaria, and 4% of children with mild malaria had an elevated serum creatinine above 62 μmol/l. Increased urinary protein excretion was frequent: 53% of children with cerebral malaria had a glomerulo‐tubular pattern of protein excretion, and 46% a tubular pattern. Median albuminuria was 68 mg/l in children with cerebral malaria, 18 mg/l in children with mild malaria, and 9 mg/l in febrile children with other diseases ( P < 0.0001). There was no significant association between the proteinuria and height of fever or the degree of parasitaemia, and there was no significant association between death and signs of renal impairment. Renal involvement is common in children with malaria in The Gambia, with prerenal, glomerular, and tubulo‐interstitial factors contributing. It is more pronounced in children with cerebral malaria than in those with mild malaria. However, renal dysfunction is relatively mild and does not indicate a worse prognosis.