Renal cortical necrosis and acute kidney injury associated with Plasmodium vivax: a neglected human malaria parasite.
Plasmodium vivax is causing increasingly more cases of severe malaria worldwide. There is an urgent need to reexamine the clinical spectrum and burden of P. vivax so that adequate control measures can be implemented against this emerging but neglected disease. Herein, we report a case of renal acute cortical necrosis and acute kidney injury (AKI) associated with P. vivax monoinfection. Her initial serum creatinine was 7.3 mg/dL on admission. Modification of Diet in Renal Disease (MDRD) Study glomerular filtration rate (GFR) value was 7 mL/min/1.73 m(2) (normal kidney function-GFR above 90 mL/min/1.73 m(2) and no proteinuria). On follow-up, 5 months later, her SCr. was 2.43 mg/dl with no proteinuria. MDRD GFR value was 24 mL/min/1.73 m(2) suggesting severe chronic kidney disease (CKD; GFR less than 60 or kidney damage for at least 3 months), stage 4. Our case report highlights the fact that P. vivax malaria is benign by name but not always by nature. AKI associated with P. vivax malaria can lead to CKD. Further studies are needed to determine why P. vivax infections are becoming more severe.
Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Dr HL Trivedi Institute of Transplantation Sciences [IKDRC-ITS], Ahmedabad, India. drvivekkute@rediffmail.com
Vivek B
VB
Kute
Aruna V
AV
Vanikar
Pramod P
PP
Ghuge
Jitendra G
JG
Goswami
Mohan P
MP
Patel
Himanshu V
HV
Patel
Manoj R
MR
Gumber
Pankaj R
PR
Shah
Hargovind L
HL
Trivedi
D058186:Acute Kidney Injury / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology*; D000328:Adult; D003404:Creatinine / Q000097:blood; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000473:pathology / Q000503:physiopathology; D007673:Kidney Cortex Necrosis / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology*; D016780:Malaria, Vivax / Q000150:complications / Q000175:diagnosis* / Q000473:pathology*; D010966:Plasmodium vivax / Q000472:pathogenicity*
D003404:Creatinine