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Kidney Week

Abstract: SA-PO056

A Unique Case of Acute Renal Failure With Plasmodium Falciparum Requiring Renal Replacement Therapy

Session Information

Category: Acute Kidney Injury

  • 102 AKI: Clinical‚ Outcomes‚ and Trials

Authors

  • Batool, Aisha, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
  • Chaudhry, Shahzad, Aurora Health Care, Milwaukee, Wisconsin, United States
  • Batool, Khadija, Services Institute of Medical Sciences, Lahore, Punjab, Pakistan
  • Omar, Muhammad Ali, TidalHealth Nanticoke, Seaford, Delaware, United States
Introduction

Malaria is a serious and endemic parasitic disease in the developing world, causing high morbidity and mortality. Plasmodium falciparum is one of the five protozoa responsible for serious disease manifesting as endorgan damage particularly Acute Renal Failure.

Case Description

Our patient is a 54-year-old male of East African origin. Five days after his return from Uganda, he presented to the Emergency room with high grade fever, rigors, black urination and lethargy. In Emergency Room he was found to have Acute Renal Failure with BUN 106 mg/dl, Serum Creatine 5.62 mg/dl and Total Bilirubin 9.5 mg/dl. Rapid Malaria antigen was positive for Plasmodium Falciparum with peripheral blood Parasitemia level of 9.5%. He was admitted to the Intensive Care Unit and started on Intravenous artesunate 2.4 mg/kg. Given the severity of his electrolyte abnormalities and Acute Renal Failure, he was started on intermittent Hemodialysis. Patient was given a total of two sessions of Hemodialysis with enough renal recovery to come off Hemodialysis.

Discussion

Plasmodium Falciparum is being accounted for more than 90% of the world’s malaria mortality and remains an important threat to public health on a global scale. It causes the most serious illness called Black Water Fever and Cerebral malaria. All suspected cases of malaria should be confirmed using parasite-based diagnostic testing to swiftly distinguish between malarial and non-malarial fevers. Acute Renal Failure complicates up to 40% of Plasmodium Falciparum malaria. Most cases of malaria in the U.S. are imported and could therefore be avoided with appropriate personal protective measures and compliance with prescribed chemoprophylaxis. Healthcare providers must be educated not only on the diagnosis and treatment of malaria but especially on the importance of prevention.

Peripheral Smear showing Intra-erythrocytic Ringlet Forms of Plasmodium Falciparum