| Autor: |
Katherine Plewes, Hugh W.F. Kingston, Aniruddha Ghose, Richard J. Maude, M. Trent Herdman, Stije J. Leopold, Haruhiko Ishioka, Md. Mahtab Uddin Hasan, Md. Shafiul Haider, Shamsul Alam, Kim A. Piera, Prakaykaew Charunwatthana, Kamolrat Silamut, Tsin W. Yeo, Md. Abul Faiz, Sue J Lee, Mavuto Mukaka, Gareth D.H. Turner, Nicholas M. Anstey, L. Jackson Roberts, Nicholas J. White, Nicholas P.J. Day, Md. Amir Hossain, Arjen M. Dondorp |
| Jazyk: |
angličtina |
| Rok vydání: |
2017 |
| Předmět: |
|
| Zdroj: |
BMC Infectious Diseases, Vol 17, Iss 1, Pp 1-12 (2017) |
| Druh dokumentu: |
article |
| ISSN: |
1471-2334 |
| DOI: |
10.1186/s12879-017-2373-1 |
| Popis: |
Abstract Background Intravascular hemolysis is an intrinsic feature of severe malaria pathophysiology but the pathogenic role of cell-free hemoglobin-mediated oxidative stress in severe malaria associated acute kidney injury (AKI) is unknown. Methods As part of a prospective observational study, enrolment plasma cell-free hemoglobin (CFH), lipid peroxidation markers (F2-isoprostanes (F2-IsoPs) and isofurans (IsoFs)), red cell deformability, and serum creatinine were quantified in Bangladeshi patients with severe falciparum malaria (n = 107), uncomplicated malaria (n = 80) and sepsis (n = 28). The relationships between these indices and kidney function and clinical outcomes were examined. Results AKI was diagnosed at enrolment in 58% (62/107) of consecutive patients with severe malaria, defined by an increase in creatinine ≥1.5 times expected baseline. Severe malaria patients with AKI had significantly higher plasma cell-free hemoglobin (geometric mean CFH: 8.8 μM; 95% CI, 6.2–12.3 μM), F2-isoprostane (56.7 pg/ml; 95% CI, 45.3–71.0 pg/ml) and isofuran (109.2 pg/ml; 95% CI, 85.1–140.1 pg/ml) concentrations on enrolment compared to those without AKI (CFH: 5.1 μM; 95% CI, 4.0–6.6 μM; P = 0.018; F2-IsoPs: 27.8 pg/ml; 95% CI, 23.7–32.7 pg/ml; P |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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