Vol. 2, Issue 1, Part M (2016)

Abstract
Background: Establishment of prevalence of malaria-associated renal impairment in Nigeria is important for proper prognosis and management of malaria and its associated complications. Using biuret method for protein estimation, alkaline picrate-slot method for creatinine and urea estimation, and flame photometry and titrimetric method for electrolytes estimation, selected kidney function parametersObjective:1. To identify cases of severe malaria by performing urine dipstick test.2. To suggest early intervention in patients with renal dysfunction because of complicated malaria.3. To correlate findings of urine dipstick with serum creatinine level.4. To follow up cases if serum creatinine level is more than 1.3 mg/dl or in the presence of positive hematuria and proteinuria in urine dipstick.Methods: A duration based cross sectional study which enrolled 100 cases of smear positive malaria attending Shadan Institute of Medical Sciences, Hyderabad, Telangana, India for 18 months duration. Urine dipstick was performed in all cases to detect hematuria and proteinuria and findings were correlated with serum creatinine level. Acute kidney injury was graded on the basis of serum creatinine level. Hematuria, proteinuria, and creatinine level was reassessed after starting antimalarial treatment and fluid therapy. Early intervention was suggested in patients with renal dysfunction.Results: In the present study, 46 patients were female and 154 were male suggesting male predominance which can also be explained by other studies done in past out of 200 patients, 42 were found to have hematuria (24 patients with AKI and 18 patients with normal renal function) and 62 had proteinuria (24 patients with AKI and 38 with normal renal function). Though significantly higher values of hematuria and proteinuria were observed in patients with renal impairment than those without renal impairment.Conclusion: P. falciparum and P. Vivax malaria associated with acute kidney injury is therefore a life threatening condition, so early diagnosis and intervention with appropriate anti- malarial drugs, fluid therapy and hemodialysis is required to revert AKI, reduce mortality and morbidity. Presence of microscopic haematuria and proteinuria in urine dipstick can be a good parameter for the early detection of renal impairment in patients with malaria even when serum creatinine is normal, which also has a statistical significance (p< 0.01).