A Prospective Observational Study on Acute Kidney Injury in Patients of Falciparum and Vivax Malaria

Background: Although Plasmodium falciparum malaria is known to cause acute kidney injury (AKI), Plasmodium vivax malaria is now more often the cause of this outcome. Several recent studies have shown that P. vivax malaria also causes AKI. Examining the demographic profile, clinical traits, mortality indicators, need for dialysis, and overall outcome of patients with P. falciparum and P. vivax malaria is the aim of this study. Methods: In the Department of Medicine at Darbhanga Medical College and Hospital, Laheriasarai, Bihar, a prospective observational study comprising patients with malaria and indications of AKI was conducted from October 2023 to September 2024. The diagnosis of malaria was confirmed by Leishman’s stain-stained thick and thin peripheral smears and rapid malarial antigen testing. To investigate various parameters, an appropriate statistical analysis was carried out. Result: Out of 100 cases of P. falciparum and 110 cases of P. vivax malaria, there were 21 (21.0%) and 29 (26.36%) cases of AKI caused by P. falciparum and P. vivax malaria, respectively. In both groups, the majority of patients were under 30 years old. In both groups, females were more likely to be impacted. P. falciparum malaria frequently caused pallor, hypotension, oliguria, sepsis, and altered sensorium. Jaundice, vomiting, thrombocytopenia, hepatomegaly and splenomegaly were more common in P. vivax malaria, Oliguria, anaemia, acute respiratory distress syndrome (ARDS), Disseminated intravascular coagulopathy (DIC), cerebral malaria, hypotension, hyponatraemia, hyperbilirubinaemia were commonly associated independent risk factors for mortality in both P. falciparum and P. vivax malaria. P. falciparum and P. vivax malaria patients received antimalarial artesunate combination therapy. 6 (28.57%) cases of P. falciparum and 8 (27.58%) cases of P. vivax underwent haemodialysis. 2 (9.52%) patients of P. falciparum malaria and 4 (13.79%) patients of P. vivax malaria AKI died. Conclusion: AKI was common in P. falciparum and P. vivax-caused malaria. Malaria considerably raises morbidity and mortality in most of India. Better outcomes may arise from early detection and treatment.