Kapoor Kapil, Gupta Shalu
Department of Paediatrics, Maulana Azad Medical College and Associated Chacha Nehru Bal Chikitsalaya, Delhi, India.
Trop Doct. 2012 Oct;42(4):203-5. doi: 10.1258/td.2012.120196. Epub 2012 Aug 6.
Acute kidney injury (AKI) is a serious complication of malaria which has a very high mortality rate. A retrospective analysis of medical record data of children treated for malarial AKI in a paediatric intensive care unit (PICU) was performed in order to evaluate the incidence, poor prognostic factors and outcome of AKI with malaria. Eighteen (48.6%) malarial patients had AKI (11 Plasmodium vivax positive, six P. falciparum positive and one mixed infection) with a male-to-female ratio of 1:2. The mean age was 75 ± 32 months (range, 1 month to 10 years). Oliguria was present in 61.1% and 55.5% required renal replacement therapy. Mortality was noted in 33.3% of patients and full recovery was achieved in 50% of patients. Oliguria, shock, central nervous system involvement, jaundice, disseminated intravascular coagulopathy and acute respiratory distress syndrome emerged as bad prognostic factors in simple univariate analysis. Malaria patients with and without AKI differ significantly in terms of shock, ventilator requirement, mortality and length of PICU stay.
急性肾损伤（AKI）是疟疾的一种严重并发症，死亡率极高。为了评估疟疾相关急性肾损伤的发病率、不良预后因素及转归，对一家儿科重症监护病房（PICU）中接受治疗的疟疾相关急性肾损伤患儿的病历数据进行了回顾性分析。18例（48.6%）疟疾患者发生了急性肾损伤（11例间日疟原虫阳性，6例恶性疟原虫阳性，1例混合感染），男女比例为1:2。平均年龄为75±32个月（范围1个月至10岁）。61.1%的患者出现少尿，55.5%的患者需要肾脏替代治疗。33.3%的患者死亡，50%的患者完全康复。在单因素分析中，少尿、休克、中枢神经系统受累、黄疸、弥散性血管内凝血和急性呼吸窘迫综合征成为不良预后因素。有和没有急性肾损伤的疟疾患者在休克、呼吸机需求、死亡率和PICU住院时间方面存在显著差异。
