Acidosis and acute kidney injury in severe malaria

<p><strong>Background</strong><br/>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 pa...

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Main Authors: Sriboonvorakul, N, Ghose, A, Hassan, M, Hossain, M, Faiz, M, Pukrittayakamee, S, Chotivanich, K, Sukthana, Y, Leopold, S, Plewes, K, Day, N, White, N, Tarning, J, Dondorp, A
Format: Journal article
Language:English
Published: BioMed Central 2018
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author Sriboonvorakul, N
Ghose, A
Hassan, M
Hossain, M
Faiz, M
Pukrittayakamee, S
Chotivanich, K
Sukthana, Y
Leopold, S
Plewes, K
Day, N
White, N
Tarning, J
Dondorp, A
author_facet Sriboonvorakul, N
Ghose, A
Hassan, M
Hossain, M
Faiz, M
Pukrittayakamee, S
Chotivanich, K
Sukthana, Y
Leopold, S
Plewes, K
Day, N
White, N
Tarning, J
Dondorp, A
author_sort Sriboonvorakul, N
collection OXFORD
description <p><strong>Background</strong><br/>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.</p> <p><strong>Methods</strong><br/>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.</p> <p><strong>Results</strong><br/>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 &lt; 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.</p> <p><strong>Conclusions</strong><br/>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.</p>
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spelling oxford-uuid:e7f505d7-c324-4e71-8892-6f7c43891f0d2022-03-27T10:43:06ZAcidosis and acute kidney injury in severe malariaJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:e7f505d7-c324-4e71-8892-6f7c43891f0dEnglishSymplectic Elements at OxfordBioMed Central2018Sriboonvorakul, NGhose, AHassan, MHossain, MFaiz, MPukrittayakamee, SChotivanich, KSukthana, YLeopold, SPlewes, KDay, NWhite, NTarning, JDondorp, A<p><strong>Background</strong><br/>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.</p> <p><strong>Methods</strong><br/>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.</p> <p><strong>Results</strong><br/>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 &lt; 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.</p> <p><strong>Conclusions</strong><br/>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.</p>
spellingShingle Sriboonvorakul, N
Ghose, A
Hassan, M
Hossain, M
Faiz, M
Pukrittayakamee, S
Chotivanich, K
Sukthana, Y
Leopold, S
Plewes, K
Day, N
White, N
Tarning, J
Dondorp, A
Acidosis and acute kidney injury in severe malaria
title Acidosis and acute kidney injury in severe malaria
title_full Acidosis and acute kidney injury in severe malaria
title_fullStr Acidosis and acute kidney injury in severe malaria
title_full_unstemmed Acidosis and acute kidney injury in severe malaria
title_short Acidosis and acute kidney injury in severe malaria
title_sort acidosis and acute kidney injury in severe malaria
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