Weber M W, Böker K, Horstmann R D, Ehrich J H
Kinderklinik, Medizinische Hochschule, Hannover, Germany.
Trop Med Parasitol. 1991 Jun;42(2):115-8.
Renal failure in malaria appears to be a complication less well known than anaemia and cerebral malaria. Thirty-one non-immune patients treated for Plasmodium falciparum malaria at Hannover Medical School were reviewed. Nine patients (29%) had acute renal failure, seven of whom required dialysis, and five patients needed mechanical ventilation. Cerebral symptoms were seen in nine patients, and three of the patients died. In a second series, information about patients who died of malaria in Germany and Austria was gathered. Thirty-six reports were obtained and analysed retrospectively. Thirty-four patients (94%) had acute renal failure. Eighteen patients received dialysis while five other patients with high central venous pressure or hyperkalaemia would have benefitted from dialysis. Cerebral involvement was seen in 34 patients, and 20 patients showed respiratory failure. It was concluded that renal failure in P. falciparum malaria is as common in non-immune adults as cerebral malaria. As untreated renal failure may have a deleterious influence on cerebral and respiratory functions, early dialysis-treatment in patients with severe P. falciparum malaria and signs of deteriorating renal function is recommended.
疟疾导致的肾衰竭似乎是一种不如贫血和脑型疟疾那么为人熟知的并发症。对汉诺威医学院收治的31例接受恶性疟原虫疟疾治疗的非免疫患者进行了回顾性研究。9例患者（29%）出现急性肾衰竭，其中7例需要透析，5例需要机械通气。9例患者出现脑部症状，3例患者死亡。在第二个系列研究中，收集了德国和奥地利死于疟疾患者的信息。共获得36份报告并进行回顾性分析。34例患者（94%）出现急性肾衰竭。18例患者接受了透析治疗，另有5例中心静脉压高或血钾高的患者本可从透析中获益。34例患者出现脑部病变，20例患者出现呼吸衰竭。研究得出结论，在非免疫成年人中，恶性疟原虫疟疾导致的肾衰竭与脑型疟疾一样常见。由于未经治疗的肾衰竭可能对脑功能和呼吸功能产生有害影响，因此建议对患有严重恶性疟原虫疟疾且有肾功能恶化迹象的患者尽早进行透析治疗。
