Malaria and Renal Failure

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QUESTION

Explain how malaria can cause renal failure?

ANSWER

There are several mechanisms by which malaria can contribute to renal failure, which vary due to the type of malaria. The exact way in which these various effects combine to cause acute renal failure is not known.

The most common type of malaria to cause renal failure is Plasmodium falciparum, generally the most severe and deadly form of the disease. P. falciparum infected red blood cells are known to sequester in tiny red blood cells deep within major organs, including the kidney; it is thought that reduced blood flow and resulting lack of oxygen may contribute to renal failure. Exaggerated immune response to infection may also be a major contributor to renal failure—this is most likely to cause of renal complications seen in other forms of malaria infection, such as Plasmodium malariae infection.

Moreover, acute renal failure is more usually observed in non-immune adults to malaria (such as those who did not grow up in malaria areas) or older children, again suggesting an involvement of the immune response. Finally, dehydration, associated with a lack of sufficient fluid intake during illness with malaria, may compound these other issues, and contribute to renal failure. Perhaps counterintuitively, administration of intravenous fluids may actually worsen the system, due to the body’s shock-like response to the sudden increase in fluids.

Can malaria cause kidney failure?

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QUESTION:

Can malaria be a cause for kidney failure or brain fever?

ANSWER:

Malaria, and specifically Plasmodium falciparum malaria, the most severe and deadly form of the disease, can certainly cause both renal failure and brain fever. It usually does this by infecting red blood cells, which then become blocked in tiny blood vessels deep within organs. This process is called sequestration. When sequestration happens in the brain, the effect can be so-called “cerebral malaria” or brain fever. In the kidney, this can result in kidney failure. Given these severe consequences, it is crucially important to seek diagnosis and then treatment immediately if you are concerned you might be suffering from malaria.