Acidosis and acute kidney injury in severe malaria
Abstract Background In severe falciparum malaria metabolic acidosis and acute kidney injury (AKI) are independent predictors of a fatal outcome in all age groups. The relationship between plasma acids, urine acids and renal function was investigated in adult patients with acute falciparum malaria. M...
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doaj-059e025d76924aaca904668df48f344f2020-11-25T00:36:28ZengBMCMalaria Journal1475-28752018-03-011711810.1186/s12936-018-2274-9Acidosis and acute kidney injury in severe malariaNatthida Sriboonvorakul0Aniruddha Ghose1M. Mahtab Uddin Hassan2Md. Amir Hossain3M. Abul Faiz4Sasithon Pukrittayakamee5Kesinee Chotivanich6Yaowalark Sukthana7Stije J. Leopold8Katherine Plewes9Nicholas P. J. Day10Nicholas J. White11Joel Tarning12Arjen M. Dondorp13Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol UniversityChittagong Medical College HospitalChittagong Medical College HospitalChittagong Medical College HospitalChittagong Medical College HospitalDepartment of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol UniversityDepartment of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol UniversityDepartment of Protozoology, Faculty of Tropical Medicine, Mahidol UniversityMahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol UniversityMahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol UniversityMahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol UniversityMahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol UniversityMahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol UniversityMahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol UniversityAbstract Background In severe falciparum malaria metabolic acidosis and acute kidney injury (AKI) are independent predictors of a fatal outcome in all age groups. The relationship between plasma acids, urine acids and renal function was investigated in adult patients with acute falciparum malaria. Methods Plasma and urinary acids which previously showed increased concentrations in proportion to disease severity in patients with severe falciparum malaria were quantified. Patients with uncomplicated malaria, sepsis and healthy volunteers served as comparator groups. Multiple regression and multivariate analysis were used to assess the relationship between organic acid concentrations and clinical syndromes, in particular AKI. Results Patients with severe malaria (n = 90), uncomplicated malaria (n = 94), non-malaria sepsis (n = 19), and healthy volunteers (n = 61) were included. Univariate analysis showed that both plasma and creatinine-adjusted urine concentrations of p-hydroxyphenyllactic acid (pHPLA) were higher in severe malaria patients with AKI (p < 0.001). Multiple regression analysis, including plasma or creatinine-adjusted urinary acids, and PfHRP2 as parasite biomass marker as independent variables, showed that pHPLA was independently associated with plasma creatinine (β = 0.827) and urine creatinine (β = 0.226). Principal component analysis, including four plasma acids and seven urinary acids separated a group of patients with AKI, which was mainly driven by pHPLA concentrations. Conclusions Both plasma and urine concentrations of pHPLA closely correlate with AKI in patients with severe falciparum malaria. Further studies will need to assess the potential nephrotoxic properties of pHPLA.http://link.springer.com/article/10.1186/s12936-018-2274-9Severe malariaAcidosisAcute kidney injury |
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DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Natthida Sriboonvorakul Aniruddha Ghose M. Mahtab Uddin Hassan Md. Amir Hossain M. Abul Faiz Sasithon Pukrittayakamee Kesinee Chotivanich Yaowalark Sukthana Stije J. Leopold Katherine Plewes Nicholas P. J. Day Nicholas J. White Joel Tarning Arjen M. Dondorp |
spellingShingle |
Natthida Sriboonvorakul Aniruddha Ghose M. Mahtab Uddin Hassan Md. Amir Hossain M. Abul Faiz Sasithon Pukrittayakamee Kesinee Chotivanich Yaowalark Sukthana Stije J. Leopold Katherine Plewes Nicholas P. J. Day Nicholas J. White Joel Tarning Arjen M. Dondorp Acidosis and acute kidney injury in severe malaria Malaria Journal Severe malaria Acidosis Acute kidney injury |
author_facet |
Natthida Sriboonvorakul Aniruddha Ghose M. Mahtab Uddin Hassan Md. Amir Hossain M. Abul Faiz Sasithon Pukrittayakamee Kesinee Chotivanich Yaowalark Sukthana Stije J. Leopold Katherine Plewes Nicholas P. J. Day Nicholas J. White Joel Tarning Arjen M. Dondorp |
author_sort |
Natthida Sriboonvorakul |
title |
Acidosis and acute kidney injury in severe malaria |
title_short |
Acidosis and acute kidney injury in severe malaria |
title_full |
Acidosis and acute kidney injury in severe malaria |
title_fullStr |
Acidosis and acute kidney injury in severe malaria |
title_full_unstemmed |
Acidosis and acute kidney injury in severe malaria |
title_sort |
acidosis and acute kidney injury in severe malaria |
publisher |
BMC |
series |
Malaria Journal |
issn |
1475-2875 |
publishDate |
2018-03-01 |
description |
Abstract Background In severe falciparum malaria metabolic acidosis and acute kidney injury (AKI) are independent predictors of a fatal outcome in all age groups. The relationship between plasma acids, urine acids and renal function was investigated in adult patients with acute falciparum malaria. Methods Plasma and urinary acids which previously showed increased concentrations in proportion to disease severity in patients with severe falciparum malaria were quantified. Patients with uncomplicated malaria, sepsis and healthy volunteers served as comparator groups. Multiple regression and multivariate analysis were used to assess the relationship between organic acid concentrations and clinical syndromes, in particular AKI. Results Patients with severe malaria (n = 90), uncomplicated malaria (n = 94), non-malaria sepsis (n = 19), and healthy volunteers (n = 61) were included. Univariate analysis showed that both plasma and creatinine-adjusted urine concentrations of p-hydroxyphenyllactic acid (pHPLA) were higher in severe malaria patients with AKI (p < 0.001). Multiple regression analysis, including plasma or creatinine-adjusted urinary acids, and PfHRP2 as parasite biomass marker as independent variables, showed that pHPLA was independently associated with plasma creatinine (β = 0.827) and urine creatinine (β = 0.226). Principal component analysis, including four plasma acids and seven urinary acids separated a group of patients with AKI, which was mainly driven by pHPLA concentrations. Conclusions Both plasma and urine concentrations of pHPLA closely correlate with AKI in patients with severe falciparum malaria. Further studies will need to assess the potential nephrotoxic properties of pHPLA. |
topic |
Severe malaria Acidosis Acute kidney injury |
url |
http://link.springer.com/article/10.1186/s12936-018-2274-9 |
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