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- Title
Urinary bile casts in bile cast nephropathy secondary to severe falciparum malaria.
- Authors
Mohapatra, Manoj Kumar; Behera, Ashok Kumar; Karua, Purna Chandra; Bariha, Prafulla Kumar; Rath, Ashutosh; Aggrawal, Kailash Chandra; Nahak, Snigdha Rani; Gudaganatti, Santosh Shankar
- Abstract
Background: Severe cholestatic jaundice may complicate with bile cast nephropathy (BCN) causing severe acute kidney injury (AKI). In this study, we investigate BCN in severe falciparum malaria complicated with jaundice and AKI. Methods: This prospective study was conducted in a tertiary health care institution with high prevalence of malaria. A cohort of 110 patients with falciparum malaria complicated with cerebralmalaria, jaundice and AKI were enrolled. Species diagnosis was made fromperipheral blood smear or rapid diagnostic test. Severemalariawas diagnosed fromWHO criteria. BCNwas diagnosed with the detection of bile casts in urine or in biopsy. The recovery pattern and outcome with and without BCN was assessed. Results: Out of 110 patients, 20 (18.2%) patients had BCN and 15 (13.6%) patients had hepato-renal syndrome. Patients with BCN had high conjugated bilirubin (26.5 ± 4.1 mg/dL), urea (75.9 ± 10.3 mg/dL) and creatinine (7.2 ± 0.8 mg/dL), longer duration of illness (6.4 ± 1.1 days), higher mortality (25.0%) and prolonged recovery time of hepatic (9.6 ± 2.4 days) and renal dysfunction (15.1 ± 6.5 days) compared with patients without BCN. Conclusions: Prolonged duration of illness and increased bilirubin cause BCN among patients with severe falciparum malaria with jaundice and AKI, which is associated with high mortality and morbidity.
- Subjects
OBSTRUCTIONS of the bile ducts; HEPATORENAL syndrome; ACUTE kidney failure
- Publication
Clinical Kidney Journal, 2016, Vol 9, Issue 4, p644
- ISSN
2048-8505
- Publication type
Article
- DOI
10.1093/ckj/sfw042