Malaria

Of the four pathogenic malarial species, clinically significant renal dysfunction is mainly associated with Plasmodium malariae and Plasmodium falciparum infections.P. falciparum infection frequently causes acute kidney injury (AKI). AKI may be the sole manifestation with a complete recovery after treatment or it may be a part of multi-organ failure which is often fatal. AKI due to Plasmodium vivax infection alone or as a result of mixed infection by vivax and falciparum can also occur.‘Quartan malarial nephropathy’ has been attributed to P. malariae infection although this relationship must be regarded as not proven. It describes nephropathy occurring predominantly in children and young adults in Africa. A full-blown nephrotic syndrome is seen in about half the patients and a chronic progressive membranoproliferative glomerulonephritis is usually seen on histology. Spontaneous remission of established nephropathy is rare, and most patients slowly progress to end-stage renal failure over 3 to 5 years even after successful eradication of the infection. The pathological description is such that it could have alternative aetiologies, including other infections.