Brown Denver D, Solomon Sonia, Lerner Daniele, Del Rio Marcela
Department of Pediatric Nephrology at The Children's Hospital at Montefiore, 3326 Bainbridge Ave, Bronx, NY, 10029, USA.
Pediatr Nephrol. 2020 Apr;35(4):603-608. doi: 10.1007/s00467-018-4191-0. Epub 2019 Jan 31.
Malaria is a parasitic infection transmitted by mosquitos, resulting in significant morbidity and mortality. It affects 212 million worldwide, causing death in up to 303,000 children annually. In the USA, up to 1700 people are affected yearly. Although the prevalence in developed countries is less than in developing countries, travelers from low transmission areas, and those from endemic areas who later return, are very susceptible to malaria and its complications. Severe malaria can cause significant multiorgan dysfunction including acute kidney injury (AKI). The pathogenesis is not clearly understood but proposed mechanisms include acute tubular necrosis (ATN) due to impediments in renal microcirculation, infection-triggered proinflammatory reactions within the kidney, and metabolic disturbances. Providers must consider malarial infection in cases of AKI in someone with a travel history, as early recognition and treatment are crucial to improving outcomes. This article will review malaria-induced AKI in order to provide a better understanding of this infection's effect on the kidneys.
疟疾是一种由蚊子传播的寄生虫感染，会导致严重的发病和死亡。全球有2.12亿人受其影响，每年多达30.3万名儿童因此死亡。在美国，每年有多达1700人受到影响。尽管发达国家的发病率低于发展中国家，但来自低传播地区的旅行者以及后来返回的流行地区的人，极易感染疟疾及其并发症。严重疟疾可导致严重的多器官功能障碍，包括急性肾损伤（AKI）。其发病机制尚不清楚，但提出的机制包括由于肾微循环障碍导致的急性肾小管坏死（ATN）、肾脏内感染引发的促炎反应以及代谢紊乱。对于有旅行史的急性肾损伤患者，医疗人员必须考虑疟疾感染，因为早期识别和治疗对于改善预后至关重要。本文将综述疟疾诱发的急性肾损伤，以便更好地了解这种感染对肾脏的影响。
