A study in MalariaWorld this week found a strong link between malaria and acute kidney injury (AKI) in paediatric patients in Nigeria. ‘A study using point of care creatinine testing in a Nigerian primary health care centre: Malaria as the leading cause of Acute Kidney Injury particularly in children’ by Ugwem-Ikuru et al published in Nephron was conducted at Ozuoba Model Comprehensive Primary Health Care Centre in Nigeria.
The study found that while just 0.6% of adult patients had AKI found by testing creatinine, AKI was found in 56.9% of children and malaria in 69.9%. The majority of AKI cases had malaria and it was more prevalent in younger patients. There is a high prevalence of both malaria, detected using lateral flow immunochromatography (STANDARD Q Malaria P.f/Pan Ag Test) to detect Plasmodium antigens in a finger-prick sample of blood, and AKI measured using POC Cr technology StatSensor Xpress Creatinine test.
High levels of creatinine suggest poor kidney function. The occurrence may be due to use of non-steroidal anti-inflammatory drugs commonly used as to reduce fever (paracetamol, ibuprofen etc). The authors point out that the vulnerability of the paediatric population may be due to an immature immune system. The linkage of the two conditions suggests a common cause and general poor health of children in the region. Severe AKI is a common feature of severe malaria occurring in up to 45% of adult patients as well.
It is possible that two conditions have common causes.