Factors Associated with Acute Renal Failure in Severe Falciparum Malaria Patients

Acute renal failure (ARF) is a common cause of morbidity and mortality in severe malaria infection. We evaluated factors associated with acute renal failure in severe malaria by comparing patients with severe malaria with and without ARF admitted to the Hospital for Tropical Diseases, Bangkok, Thailand. Nine hundred fifteen severe malaria patients were included in the study, of whom 195 had ARF and 720 did not have ARF. We found jaundice, anemia, hypoalbuminemia, hyponatremia, hyperkalemia, acidosis, leukocytosis, elevated transaminases (SGOT and SGPT) and cerebral malaria, were significantly associated with ARF among patients with severe malaria (p<0.05). Patients who have ARF and any of these clinical or laboratory manifestations of severe malaria should be monitored and managed properly, since early detection and treatment may reduce morbidity and mortality.