Urinary bile casts in bile cast nephropathy secondary to severe falciparum malaria
| Autor: | Kailash Chandra Aggrawal, Purna Chandra Karua, Ashutosh Rath, Manoj Kumar Mohapatra, Prafulla Kumar Bariha, Santosh Shankar Gudaganatti, Ashok Kumar Behera, Snigdha Rani Nahak |
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| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
Bilirubin Urinary system bile casts 030232 urology & nephrology Gastroenterology Nephropathy 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Internal medicine parasitic diseases medicine hepato-renal syndrome Prospective cohort study jaundice-related nephropathy Transplantation business.industry Acute kidney injury Jaundice medicine.disease Surgery Haemodialysis chemistry Nephrology Cerebral Malaria cholemic nephrosis 030211 gastroenterology & hepatology medicine.symptom business Malaria |
| Zdroj: | Clinical Kidney Journal |
| ISSN: | 2048-8513 2048-8505 |
| DOI: | 10.1093/ckj/sfw042 |
| Popis: | 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 cerebral malaria, jaundice and AKI were enrolled. Species diagnosis was made from peripheral blood smear or rapid diagnostic test. Severe malaria was diagnosed from WHO criteria. BCN was 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. |
| Databáze: | OpenAIRE |
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