Species implicated in acute malarial nephropathy:
(1) Plasmodium falciparum (most)
(2) Plasmodium vivax (few)
Components of the nephropathy:
(1) acute tubular necrosis
(2) acute interstitial nephritis
(3) proliferative and/or exudative glomeulonephritis
Clinical features:
(1) onset during acute malaria, usually in nonimmune individuals
(2) hematuria
(3) occasional nephrotic syndrome
(4) jaundice
(5) oliguria or anuria
(6) usual recovery of renal function with adequate therapy of the malaria, renal replacement therapy and avoidance of nephrotoxic drugs
(7) may be associated with a high mortality rate if associated with multi-organ failure in severe malaria
Laboratory features:
(1) anemia
(2) thrombocytopenia
(3) occasional evidence of DIC
(4) elevated serum creatinine
(5) proteinuria, which occasionally may be in the nephrotic range
(6) variable myoglobinuria
(7) hyponatremia secondary to increased urinary sodium wastage
(8) hyperbilirubinemia with no or minor transaminase elevations
(9) hypoglycemia
(10) hemoglobin casts with glomerulonephritis
