A study of correlation between hepatic and renal dysfunction in malarial patients in Rajasthan, India

Abstract

Background: Our purpose of this study is to evaluate the correlation between hepatic and renal dysfunction due to falciparum malaria and vivax malaria in this region. Methods: This study had conducted on patients of malaria admitted in wards in the department of pediatrics, SMS Medical College, Jaipur, Rajasthan during the resurgence of various outbreaks of malaria in the year January 2015 to December 2015. The diagnosis of malaria has confirmed by examination of thick and thin smear/optimal tests . Results: The mean age of patients with hepato and /or renal dysfunction in malaria was 5-10 years and M:F ratio observed is 2:1. Association between serum bilirubin level and development of renal failure was significant, as 8 (100%) out of 8 patients with serum bilirubin >10 mg/dl had renal failure. Incidence of renal failure in malaria patients with hepatic dysfunction was found to be 22.2% (20 out of 90). Oliguric renal failure was present in 13 (43.33%) of patient with malarial renal dysfunction who had renal failure and 17 (56.67%) had non-oliguric renal failure. Association between hepatic and renal dysfunction was significant as 9 (40.9%) out of 22 patients with serum bilirubin > 3 mg/dl had renal failure in P. falciparum and 5 (71.43%) out of 7 patients in mixed (P.V. and P.F.) patients. This association was not significant in P. vivax as 6 (10.52%) out of 57 patient with serum bilirubin >3 mg/dl had renal failure. Conclusions: In this hospital based observational study we observed that ARF was more common in subjects who have jaundice and incidence increased with higher level of bilirubin in malaria Early diagnosis of ARF and intervention in subjects who have hepatic dysfunction in malaria can save many lives.