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Acidosis and acute kidney injury in severe malaria.
Sriboonvorakul, Natthida; Ghose, Aniruddha; Hassan, M Mahtab Uddin; Hossain, Md Amir; Faiz, M Abul; Pukrittayakamee, Sasithon; Chotivanich, Kesinee; Sukthana, Yaowalark; Leopold, Stije J; Plewes, Katherine; Day, Nicholas P J; White, Nicholas J; Tarning, Joel; Dondorp, Arjen M.
Afiliação
  • Sriboonvorakul N; Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
  • Ghose A; Chittagong Medical College Hospital, Chittagong, Bangladesh.
  • Hassan MMU; Chittagong Medical College Hospital, Chittagong, Bangladesh.
  • Hossain MA; Chittagong Medical College Hospital, Chittagong, Bangladesh.
  • Faiz MA; Chittagong Medical College Hospital, Chittagong, Bangladesh.
  • Pukrittayakamee S; Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
  • Chotivanich K; Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
  • Sukthana Y; Department of Protozoology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
  • Leopold SJ; Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithi Road, Bangkok, 10400, Thailand.
  • Plewes K; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK.
  • Day NPJ; Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithi Road, Bangkok, 10400, Thailand.
  • White NJ; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK.
  • Tarning J; Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithi Road, Bangkok, 10400, Thailand.
  • Dondorp AM; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK.
Malar J ; 17(1): 128, 2018 Mar 23.
Article em En | MEDLINE | ID: mdl-29566677
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 (ß = 0.827) and urine creatinine (ß = 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.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Fenilpropionatos / Acidose / Malária Falciparum / Sepse / Injúria Renal Aguda Tipo de estudo: Prognostic_studies Limite: Adult / Female / Humans / Male / Middle aged País como assunto: Asia Idioma: En Ano de publicação: 2018 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Fenilpropionatos / Acidose / Malária Falciparum / Sepse / Injúria Renal Aguda Tipo de estudo: Prognostic_studies Limite: Adult / Female / Humans / Male / Middle aged País como assunto: Asia Idioma: En Ano de publicação: 2018 Tipo de documento: Article