Oliguric and non-oliguric acute renal failure in malaria in west zone of rajasthan, India-A comparative study

Abstract Objective To report a comparative clinical and histopathological study on oliguric and non-oliguric acute renal failure (ARF) in malaria. Method 311 consecutive cases of malaria out of which 74 (23.79%) had ARF as per WHO criteria were conducted. Mean age was 32.58 (range 15–60 years) and male: female was 2:1. Result Most of the cases developed ARF within 10 d of onset. 18 cases (11 falciparum, 2 mixed, 5 vivax) presented with oliguric and 56 (41 falciparum, 6 mixed, 9 vivax) with non-oliguric renal failure. Associated major manifestations were jaundice (75.68%), cerebral malaria (41.89%), bleeding manifestations (32.43%), severe anemia (27.03%), hypotension (25.68%), multi-organ failure (18.92%), severe thrombocytopenia (12.16%), and ARDS (8.11%). Kidney biopsy ( n =20) showed acute tubular necrosis ( n =7), Mesangioproliferative glomerulonephritis ( n =4) or both ( n =9). Hemodialysis was done in 8 cases of oliguric renal failure out of which 4 survived (average no. of session 2.9). Conclusion Most of the cases recovered within 3 weeks. Total mortality was 28.38% ( n =21) and mortality was more in oliguric renal failure (72.22%) as compare to non-oliguric renal failure (14.29%).