The kidney in malaria: Renal and systemic haemodynamics

Summary: Renal and systemic haemodynamic alterations in malaria vary with the severity of infection. In mild malaria there is no change in renal and systemic haemodynamics. In moderate infection hypervolaemia, increased cardiac index and decreased, systemic vascular resistance are noted. the renal blood flow and glomerular filtration rate are decreased, accompanied by an increase in plasma arginine vasopressin, norepinephrine and renin activity. Yet in some patients only plasma arginine vasopressin and blood volume are increased while renal and systemic haemodynamics are normal. In severe infection blood volume is either normal or decreased; the cardiac index and systemic vascular resistance are normal, while the renal blood flow and glomerular filtration rate are markedly decreased, leading to renal failure.