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Epidemiology, pathophysiology, management and outcome of renal dysfunction associated with plasmodia infection

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Abstract

Malaria remains a serious health problem in many parts of the world. It causes high morbidity and claims many lives in developing countries each year. Humans are generally infected by four species of malaria parasites. However, malaria infection caused by Plasmodium malariae or P. falciparum is recognized as an important cause of acute renal failure (ARF) and other renal-related disorders (nephropathy) in infected patients. The increasing incidence of malarial ARF (MARF) and the emergence of clinical malarial infection after renal transplantation represent a serious challenge. Additionally, the impact of immunosuppressive therapies on malarial infection is intricate, complex, and not yet well defined. Pathogenesis of MARF is most likely to be due to immune complex-mediated glomerulonephritis caused by immune-complex deposition and endothelial damage, which may lead to fatal forms of quartan malarial nephropathies. Effects of mechanical, immunologic, cytokine, humoral, acute phase response, and hemodynamics factors in inducing malarial nephropathy have also been postulated. Development of preventive strategies aimed at combating MARF and other renal disorders associated with malaria infection requires (1) prevention of malarial infection, (2) early diagnosis, and (3) early referral to well-equipped centers to provide renal replacement therapy, if necessary, along with antimalarial therapy and support. These measures could significantly reduce mortality and enhance recovery of renal function.

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References

  • Abdurrahman MB, Aikhionbare HA, Babaoye FA, Sathiakumar N, Narayana PT (1990) Clinicopathological features of childhood nephrotic syndrome in northern Nigeria. Q J Med 75:563–576

    PubMed  CAS  Google Scholar 

  • Aikawa M, Jacobs G, Whiteley HE, Igarashi I, Ristic M (1988) Glomerulopathy in squirrel monkeys with acute Plasmodium falciparum infection. Am J Trop Med Hyg 38:7–14

    PubMed  CAS  Google Scholar 

  • Anteyi EA, Liman HM, Gbaji A (2003) Malaria prophylaxis in post renal transplant recipients in the tropics: is it necessary? Cent Afr J Med 49:63–66

    PubMed  CAS  Google Scholar 

  • Barsoum RS (1998) Malarial nephropathies. Nephrol Dial Transplant 13:1588–1597

    Article  PubMed  CAS  Google Scholar 

  • Barsoum RS (2000) Malarial acute renal failure. J Am Soc Nephrol 11:2147–2154

    PubMed  CAS  Google Scholar 

  • Barsoum R, Sitprija V (1996) Tropical nephrology. In: Schrier RW, Gottaschalk CW (eds) Diseases of the kidney, 6th edn. Little Brown, Boston, pp 2221–2268

    Google Scholar 

  • Bell A, Wernli B, Franklin RM (1994) Roles of peptidyl-prolyl cis-trans isomerase and calcineurin in the mechanisms of antimalarial action of cyclosporin A, FK506, and rapamycin. Biochem Pharmacol 48:495–503

    Article  PubMed  CAS  Google Scholar 

  • Bell A, Roberts HC, Chappell LH (1996) The antiparasite effects of cyclosporin A: possible drug targets and clinical applications. Gen Pharmacol 27:963–971

    PubMed  CAS  Google Scholar 

  • Bemelman F, De Blok K, De Vries P, Surachno S, Ten Berge I (2004) Falciparum malaria transmitted by a thick blood smear negative kidney donor. Scand J Infect Dis 36:769–771

    PubMed  Google Scholar 

  • Bhalla A, Madhavan KT, Jajoo UN (2000) Repeated peripheral smear examination for diagnosis of severe and complicated malaria. Indian J Clin Pract 11:45–46

    Google Scholar 

  • Bhalla A, Suri V, Singh V (2006) Malarial hepatopathy. J Postgrad Med 52:315–320

    PubMed  CAS  Google Scholar 

  • Bignami A, Bastianelli A (1889) Observations of estivo-autumnal fever. Reforma Med 6:1334–1335

    Google Scholar 

  • Boonpucknavig S, Boonpucknavig V, Bhamarapravati N (1972) Immunopathological studies of Plasmodium berghei-infected mice. Arch Pathol 94:322–330

    PubMed  CAS  Google Scholar 

  • Boonpucknavig V, Boonpucknavig S, Bhamarapravati N (1973) Plasmodium berghei infection in mice. An ultrastructural study of immune complex nephritis. Am J Pathol 70:89–108

    PubMed  CAS  Google Scholar 

  • Breman JG, White NJ (1994) Malaria and Babesiosis. In: Isselbacher KJ, Eugene B, Wilson JD (eds) Harrison’s principles of internal medicine, 13st edn. McGraw-Hill, New York, pp 887–896

    Google Scholar 

  • Chugh KS, Sakhuja V (1998) Glomerular disease in the tropics. In: Davison AM, Cameron JS, Grunfeld JP, Kerr DNS, Ritz E, Winearls CG (eds) Oxford textbook of clinical nephrology, 2nd edn. Oxford Univ. Press, Oxford, UK, pp 703–719

    Google Scholar 

  • Ehrich JH, Sterzel RB, Deicher HR, Foellmer HG (1981) Rat malarial glomerulonephritis. An experimental model of post-infectious glomerular injury. Virchows Arch 37:343–356

    Article  CAS  Google Scholar 

  • Eiam-Ong S (2003) Malarial nephropathy. Semin Nephrol 23:21–33

    Article  PubMed  Google Scholar 

  • Eiam-Ong S, Sitprija V (1998) Falciparum malaria and the kidney: a model of inflammation. Am J Kidney Dis 32:361–375

    PubMed  CAS  Google Scholar 

  • El-Shoura SM (1994) Falciparum malaria in naturally infected human patients: X ultrastructural pathological alterations of renal glomeruli. Parasite 1:205–210

    PubMed  CAS  Google Scholar 

  • Fischer L, Sterneck M, Claus M, Costard-Jackle A, Fleischer B, Herbst H, Rogiers X, Broelsch CE (1999) Transmission of malaria tertiana by multi-organ donation. Clin Transplant 13:491–495

    Article  PubMed  CAS  Google Scholar 

  • Gavigan CS, Kiely SP, Hirtzlin J, Bell A (2003) Cyclosporin-binding proteins of Plasmodium falciparum. Int J Parasitol 33:987–996

    Article  PubMed  CAS  Google Scholar 

  • George CR, Parbtani A, Cameron JS (1976) Mouse malaria nephropathy. J Pathol 120:235–249

    Article  PubMed  CAS  Google Scholar 

  • Giglioli G (1930) Malarial nephritis: epidemiological and clinical notes on malaria. Blackwater fever, albuminuria and nephritis in the interior of British Guiana, based on seven years’ continual observation. Churchill, London

    Google Scholar 

  • Giglioli G (1962) Malaria and renal disease with special reference to British Guiana. Ann Trop Med Parasitol 56:225–241

    PubMed  CAS  Google Scholar 

  • Giglioli G (1972) Changes in the pattern of mortality following the eradication of hyperendemic malaria from a highly susceptible community. Bull World Health Organ 46:181–202

    PubMed  CAS  Google Scholar 

  • Gilles HM, Hendrickse RG (1963) Nephrosis in Nigerian children: role of Plasmodium malariae, and effect of anti-malarial treatment. Br Med J 1:27–31

    Google Scholar 

  • Grau GE, Frei K, Piguet PF, Fontana A, Heremans H, Billiau A, Vassalli P, Lambert PH (1990) Interleukin 6 production in experimental cerebral malaria: modulation by anticytokine antibodies and possible role in hypergammaglobulinemia. J Exp Med 172:1505–1508

    Article  PubMed  CAS  Google Scholar 

  • Hendrickse RG, Adeniyi A, Edington GM, Glasgow EF, White RH, Houba V (1972) Quartan malarial nephrotic syndrome. Collaborative clinicopathological study in Nigerian children. Lancet 1:1143–1149

    Article  PubMed  CAS  Google Scholar 

  • Houba V (1979) Quartan malarial nephrotic syndrome in children. Kidney Int 16:64–69

    Article  Google Scholar 

  • Houba V, Allison AC, Adeniyi A, Houba JE (1971) Immunoglobulin classes and complement in biopsies of Nigerian children with the nephrotic syndrome. Clin Exp Immunol 8:761–774

    PubMed  CAS  Google Scholar 

  • Hung CC, Chang SC, Chen YC, Yen TS, Hsieh WC (1994) Plasmodium vivax infection in a renal transplant recipient: report of a case. J Formos Med Assoc 93:888–889

    PubMed  CAS  Google Scholar 

  • Kibukamusoke JW, Hutt MS, Wilks NE (1967) The nephrotic syndrome in Uganda and its association with quartan malaria. Q J Med 36:393–408

    PubMed  CAS  Google Scholar 

  • Kilian AH, Mughusu EB, Kabagambe G, von Sonnenburg F (1997) Comparison of two rapid, HRP2-based diagnostic tests for Plasmodium falciparum. Trans R Soc Trop Med Hyg 91:666–667

    Article  PubMed  CAS  Google Scholar 

  • Kocken CH, van der Wel A, Rosenwirth B, Thomas AW (1996) Plasmodium vivax : in vitro antiparasitic effect of cyclosporins. Exp Parasitol 84:439–443

    Article  PubMed  CAS  Google Scholar 

  • Kumar R, Adams B, Musiyenko A, Shulyayeva O, Barik S (2005a) The FK506-binding protein of the malaria parasite, Plasmodium falciparum, is a FK506-sensitive chaperone with FK506-independent calcineurin-inhibitory activity. Mol Biochem Parasitol 141:163–173

    Article  CAS  Google Scholar 

  • Kumar R, Musiyenko A, Barik S (2005b) Plasmodium falciparum calcineurin and its association with heat shock protein 90: mechanisms for the antimalarial activity of cyclosporin A and synergism with geldanamycin. Mol Biochem Parasitol 141:29–37

    Article  CAS  Google Scholar 

  • Lloyd CM, Wozencraft AO, Williams DG (1993) Cell-mediated pathology during murine malaria-associated nephritis. Clin Exp Immunol 94:398–402

    Article  PubMed  CAS  Google Scholar 

  • Mahakur AC, Panda SN, Nanda BK, Bose TK, Satpathy SR, Misra Y (1983) Malarial acute renal failure. J Assoc Phys India 31:633–616

    CAS  Google Scholar 

  • Maheshwari A, Singh AK, Sinha DK, Tripathi K, Prakash J (2004) Spectrum of renal disease in malaria. J Indian Med Assoc 102:143–148

    PubMed  Google Scholar 

  • McGregor IA, Turner MW, Williams K, Hall P (1968) Soluble antigens in the blood of African patients with severe plasmodium falciparum infection in man. Lancet 1:881–884

    Article  PubMed  CAS  Google Scholar 

  • Monaghan P, Bell A (2005) A Plasmodium falciparum FK506-binding protein (FKBP) with peptidyl–prolyl cis–trans isomerase and chaperone activities. Mol Biochem Parasitol 139:185–195

    Article  PubMed  CAS  Google Scholar 

  • Moran E, Collins L, Clayton S, Peto T, Bowler IC (2004) Case of cryptic malaria. Commun Dis Public Health 7:142–144

    PubMed  CAS  Google Scholar 

  • Nand N, Aggarwal HK, Kumar P et al (1997) Hepatic and renal dysfunction in falciparum malaria. J Assoc Phys India 45:533–534

    Google Scholar 

  • Nand N, Aggarwal HK, Sharma M, Singh M (2001) Systemic manifestations of malaria. J Indian Acad Clin Med 2(3):189–194 (July–September)

    Google Scholar 

  • Naqvi R, Ahmad E, Akhtar F, Naqvi A, Rizvi A (2003) Outcome in severe acute renal failure associated with malaria. Nephrol Dial Transplant 18:1820–1823

    Article  PubMed  Google Scholar 

  • Newbold C, Craig A, Kyes S, Rowe A, Fernadez RD, Fagan T (1999) Cytoadherance, pathogenesis and the infected red cell surface in Plasmodium falciparum. Int J Parasitol 29:927–937

    Article  PubMed  CAS  Google Scholar 

  • Nickell SP, Scheibel LW, Cole GA (1982) Inhibition by cyclosporin A of rodent malaria in vivo and human malaria in vitro. Infect Immun 37:1093–1100

    PubMed  CAS  Google Scholar 

  • Pakasa M, Mangani N, Dikassa L (1993) Focal and segmental glomerulosclerosis in nephrotic syndrome: a new profile of adult nephrotic syndrome in Zaire. Mod Path 6:125–128

    CAS  Google Scholar 

  • Pati SS, Mishra SK, Mohanty S, Pattnaik JK, Das BS (2003) Influence of renal impairment on plasma concentrations of conjugated bilirubin in cases of Plasmodium falciparum malaria. Ann Trop Med Parasitol 97:581–586

    Article  PubMed  CAS  Google Scholar 

  • Phu NH, Hien TT, Mai NTH, Chau TTH, Chuong LV, Loc PP, Winearls CG, Farrar JJ, White NJ, Day NPJ (2002) Hemofiltration and peritoneal dialysis in infection associated acute renal failure in Vietnam. N Engl J Med 347:895–902

    Article  PubMed  Google Scholar 

  • Prakash J, Gupta A, Kumar O, Rout S, Malhotra V, Srivastava P (1996) Acute renal failure in falciparum malaria: increasing prevalence in some areas of India—a need for awareness. Nephrol Dial Transplant 11:2414–2416

    PubMed  CAS  Google Scholar 

  • Prakash J, Singh AK, Gujrati S, Maheshwari A (2002) Acute renal failure in malaria: changing trends. Indian J Nephrol 12:113–117

    Google Scholar 

  • Rajapurkar MM (1994) Renal involvement in malaria. Trop Nephrol 40:132–134

    CAS  Google Scholar 

  • Romero Alvira D, Guerrero Navarro L, Gotor Lazaro MA, Roche Collado E (1995) Oxidative stress and infectious pathology. An Med Interna (Madr) 12:139–149

    CAS  Google Scholar 

  • Sachs J, Malaney P (2002) The economic and social burden of malaria. Nature 415:680–685

    Article  PubMed  CAS  Google Scholar 

  • Seggie JL, Dwomoa A (1988) Nephrotic syndrome in the Tropics. In: Cameron JS, Glassock RJ (eds) The nephrotic syndrome. Marcel Dekker, New York, NY, pp 653–695

    Google Scholar 

  • Sever MS, Ecder T, Aydin AE, Turkmen A, Kilicaslan I, Uysal V, Eraksoy H, Calangu S, Carin M, Eldegez U (1994) Living unrelated (paid) kidney transplantation in Third-World countries: high risk of complications besides the ethical problem. Nephrol Dial Transplant 9:350–354

    PubMed  CAS  Google Scholar 

  • Sheehy TW, Reba RC (1967) Complications of falciparum malaria and their treatment. Ann Intern Med 66:807–809

    PubMed  CAS  Google Scholar 

  • Shortt HE, Fairley NH, Covell G, Shute PG, Garnham PC (1951) The pre-erythrocytic stage of Plasmodium falciparum. Trans R Soc Trop Med Hyg 44:405–419

    Article  PubMed  CAS  Google Scholar 

  • Sinniah R, Churg J, Sobin LH (1988) Renal disease: classification and atlas of infectious and tropical diseases. ASCP, Chicago, IL

    Google Scholar 

  • Sinniah R, Rui-Mei L, Kara A (1999) Up-regulation of cytokines in glomerulonephritis associated with murine malaria infection. Int J Exp Pathol 80:87–95

    Article  PubMed  CAS  Google Scholar 

  • Sitprija V (1988) Nephropathy in falciparum malaria. Kidney Int 34:867–877

    Article  PubMed  CAS  Google Scholar 

  • Sitprija V, Boonpucknavig V (1994) Renal involvement in parasitic diseases. In: Tisher CC, Brenner BM (eds) Renal pathology with clinical and functional correlations. Lippincott, Philadelphia, PA, pp 626–657

    Google Scholar 

  • Thommen-Scott K (1981) Antimalarial activity of cyclosporin A. Agents Actions 11:770–773

    Article  PubMed  CAS  Google Scholar 

  • Trang TT, Phu NH, Vinh H, Hien TT, Cuong BM, Chau TT, Mai NT, Waller DJ, White NJ (1992) Acute renal failure in patients with falciparum malaria. Clin Infect Dis 15:874–880

    PubMed  CAS  Google Scholar 

  • Turkmen A, Sever MS, Ecder T, Yildiz A, Aydin AE, Erkoc R, Eraksoy H, Eldegez U, Ark E (1996) Posttransplant malaria. Transplantation 62:1521–1523

    Article  PubMed  CAS  Google Scholar 

  • van Velthuysen MLF, Florquin S (2000) Glomerulopathy associated with parasitic infections. Clin Microbiol Rev 13:55–66

    Article  PubMed  Google Scholar 

  • Voller A (1974) Immunopathology of malaria. Bull World Health Organ 50:177–186

    PubMed  CAS  Google Scholar 

  • Voller A, Draper CC, Shwe T, Hutt MS (1971) Nephrotic syndrome in monkey infected with human quartan malaria. Br Med J 4(781):208–210

    PubMed  CAS  Google Scholar 

  • Ward PA, Conran PB (1966) Immunopathologic studies of simian malaria. Mil Med 131(9:Suppl):1225–1232

    PubMed  CAS  Google Scholar 

  • Ward PA, Kibukamusoke JW (1969) Evidence for soluble immune complexes in the pathogenesis of the glomerulonephritis of quartan malaria. Lancet 1(7589):283–285

    Article  PubMed  CAS  Google Scholar 

  • Wedderburn N, Davies DR, Mitchell GH, Desgranges C, de The G (1988) glomerulonephritis in common marmosets infected with Plasmodium brasilianum and Epstein–Barr virus. J Infect Dis 158:789–794

    PubMed  CAS  Google Scholar 

  • White NJ (1996) The treatment of malaria. N Engl J Med 335:800–806

    Article  PubMed  CAS  Google Scholar 

  • World Health Organization, Division of Control of Tropical Diseases (1990) Severe and complicated malaria. Trans R Soc Trop Med Hyg 84:1–65

    Article  Google Scholar 

  • Wilairatana P, Looareesuwan S, Charoenlarp P (1994) Liver profile changes and complications in jaundiced patients with falciparum malaria. Trop Med Parasitol 45:298–302

    PubMed  CAS  Google Scholar 

  • Wilairatana P, Westerlund EK, Aursudkij B, Vannaphan S, Krudsood S, Viriyavejakul P, Chokejindachai W, Treeprasertsuk S, Srisuriya P, Gordeuk VR, Brittenham GM, Neild G, Looareesuwan S (1999) Treatment of malarial acute renal failure by hemodialysis. Am J Trop Med Hyg 60:233–237

    PubMed  CAS  Google Scholar 

  • Wozencraft AO, Lloyd CM, Staines NA, Griffiths VJ (1990) Role of DNA-binding antibodies in kidney pathology associated with murine malaria infections. Infect Immun 58:2156–2164

    PubMed  CAS  Google Scholar 

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  1. Division of Veterinary Medicine, The School of Veterinary Medicine and Science, The University of Nottingham, College Road, Sutton Bonington, Leicestershire, LE12 5RD, UK

    Hany M. Elsheikha

  2. Nephrology Unit, Urology and Nephrology Center, Faculty of Medicine, Mansoura University, Mansoura, 35516, Egypt

    Hussein A. Sheashaa

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  2. Hussein A. Sheashaa
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Elsheikha, H.M., Sheashaa, H.A. Epidemiology, pathophysiology, management and outcome of renal dysfunction associated with plasmodia infection. Parasitol Res 101, 1183–1190 (2007). https://doi.org/10.1007/s00436-007-0650-4

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