Electrolyte changes and renal functions in children with severe malaria

Abstract

Background: Electrolyte disturbances and renal impairment have been reported in patients with severe
malaria (SM). However, the contributing mechanisms are not well identified.
Objectives: The study aims to identify disturbances in electrolytes and renal functions in children with
SM and their possible pathophysiology.
Methods: The study included fifty six children with SM identified according to WHO criteria of SM.
Investigations included parasitemia; glucose; urea; creatinine; sodium; and potassium estimation. Plasma
osmolality was calculated.
Results: Children with SM had higher frequency of hyponatremia and hypokalemia than children with
uncomplicated malaria (UM). Hyperkalemia complicated 10.7% of cases of SM. Children with SM had
lower creatinine and plasma osmolality than those with UM. Children presenting with more than one of
the complications, showed higher plasma osmolality, urea levels and creatinine levels than those with UM.
Conclusions: Hyponatremia may reflect the syndrome of inappropriate ADH secretion. Hypokalemia is a
frequent complication while hyperkalemia complicates some cases. Dehydration may play a role in renal
impairment; thus fluid therapy is indicated in cases with evidence of dehydration.