Malaria and Kidney

• Autor(a) principal: Pires, A.
• Data de Publicação: 2001
• Outros Autores: Borges, A., Adragão, T., Silva, M., Borges, F.
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: https://revista.spmi.pt/index.php/rpmi/article/view/1950
• topic: malária; plasmódio falciparum; plasmódio malariae; insuficiência renal aguda; glomerulonefrite; febre biliosa hemoglobinúrica; nefropatia malárica quartã; síndroma nefrótica; malaria; Plasmodium falciparum; Plasmodium malariae; acute renal failure; glomerulonephritis; blackwater fever; quartan malarial nephropathy; nephrotic syndrome

Malaria is a parasitic disease of greatepidemiological importance in the tropics.Plasmodium falciparum and Plasmodium malariaeinfection can lead to clinically significant renaldiseases. In general, the former is an acutecomplication (acute tubular necrosis andglomerulonephritis), while malariae infection can beassociated with a chronic progressive syndrome(nephrotic syndrome with evolution to chronic renal failure).It appears that acute renal failure (ARF) infalciparum malariae cases is not directly caused bythe parasite itself, but is the result of interaction ofmechanical, immunological, and humoralcomponents. Risk factors for the development ofrenal failure include hyper-parasitaemia, shock andsevere intravascular haemolysis. Delayed treatmentof malaria and late or inadequate correction ofvolume depletion, are probable contributing factorsin some cases. The reversibility of the renal lesionhas been well shown, by the reduction in mortalityachieved by introducing peritoneal or hemodialysis,as well as following the parenteral administration ofquinine. In severe cases associated with “black waterfever” a fatal outcome is almost inevitable.A mild acute glomerulonephrits has beendocumented in many patients with acute falciparum malaria.The nephrotic syndrome may develop in patients,particularly children with repeated plasmodiummalariae infections. It seems that this entity resultsfrom chronic deposition of immune complexes in the kidney.