Burden of Renal Dysfunction in Patients with Malaria in Urban Population of Sindh, Pakistan

Objectives: To determine the frequency of renal dysfunction patients with falciparum malaria in urban population of Sindh, Pakistan. Study Design: Cross-sectional study Place and Duration: Department of Medicine, Unit-III- Ward 7, Jinnah Postgraduate Medical Centre (JPMC), Karachi, Pakistan. Material and Methods: Total 223 patients of either gender with age more than 15 years who were diagnosed cases of P. falciparum malaria were recruited. The diagnosis of malaria was established through peripheral blood film by preparing thick and thin films. Thick film were used to identify the parasites and thin film for identifying the species. The diagnosis of renal dysfunction was established by measuring serum creatinine. Creatinine level of 1.2 mg/dl was taken as cut off for for males and 1.0 mg/dl for females. Values greater than cut off labeled as renal dysfunction. Patients were excluded who had history of renal disease or who had history of nephrotoxic drugs intake. Results: Thirteen (n=13) patients were excluded who had history of renal disease or who had history of nephrotoxic drugs intake. Data of remaining 210 patients was analyzed with mean age of 40.01 years ± 13.90 SD. There were 116 males and 94 females with male to female ratio 1.23. Frequency of renal dysfunction was found to be 14.3 % (n = 30) in our study. Conclusion: A significant percentage of P. falicparum malaria patients were having renal dysfunction. Early detection of renal dysfunction compounded with high quality intensive care, early institution of renal replacement therapy and avoidance of nephrotoxic drugs should be the standard practice for the prevention and management of these patients.