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Please use this identifier to cite or link to this item: http://repository.li.mahidol.ac.th/dspace/handle/123456789/46035
Title: Acidosis and acute kidney injury in severe malaria
Authors: 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
Mahidol University
Chittagong Medical College Hospital
Nuffield Department of Clinical Medicine
Keywords: Immunology and Microbiology;Medicine
Issue Date: 23-Mar-2018
Citation: Malaria Journal. Vol.17, No.1 (2018)
Abstract: © 2018 The Author(s). 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.
URI: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85044395136&origin=inward
http://repository.li.mahidol.ac.th/dspace/handle/123456789/46035
ISSN: 14752875
Appears in Collections:Scopus 2018

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