1. Urinary liver-type fatty acid-binding protein level as a prognostic indicator of acute kidney injury secondary to severe falciparum malaria.
- Author
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Katayama Y, Shimada K, Katagiri D, Terakawa K, Sakamoto E, Niikura T, Suzuki M, Yoshizaki Y, Sato L, Yamada G, Akiyama Y, Taneda S, and Takano H
- Subjects
- Humans, Male, Prognosis, Middle Aged, Biomarkers urine, Quinine therapeutic use, Kidney pathology, Plasmodium falciparum, Biopsy, Antimalarials therapeutic use, Acute Kidney Injury etiology, Acute Kidney Injury diagnosis, Malaria, Falciparum complications, Malaria, Falciparum diagnosis, Malaria, Falciparum urine, Fatty Acid-Binding Proteins urine, Fatty Acid-Binding Proteins blood, Renal Dialysis
- Abstract
Acute kidney injury (AKI) secondary to severe falciparum malaria possesses a high mortality rate; however, a prognostic marker of renal dysfunction has not yet been identified. Thus, we reported a case of a patient with AKI secondary to falciparum malaria who underwent hemodialysis and a renal biopsy due to prolonged renal dysfunction. The male patient, in his 50 s, presented to our hospital with vomiting, diarrhea, fever, and decreased level of consciousness. The Giemsa-stained peripheral blood film revealed approximately 5% parasitemia, and a rapid diagnostic test was positive for Plasmodium falciparum. He was diagnosed with severe falciparum malaria and was started on quinine hydrochloride. Hemodialysis was initiated due to the decreased urine output and fluid retention. Subsequently, he was weaned off hemodialysis. The histopathological analysis of a renal biopsy revealed interstitial fibrosis, tubular atrophy, and chronic inflammatory cell infiltration; thus, malarial nephropathy was diagnosed. Thereafter, his renal function stabilized, and he was discharged from the hospital. The urinary liver-type fatty acid-binding protein (L-FABP) level decreased before renal function improved. Our report highlighted that long-term follow-up is essential for severe AKI secondary to malaria. The urinary L-FABP level may be a useful prognostic indicator of AKI secondary to severe falciparum malaria., Competing Interests: Declarations. Conflict of interest: This study was supported by a grant from the Japan Society for the Promotion of Science (grant number 23K07687), and the Emerging/Re-emerging Infectious Diseases Project of Japan from the Japan Agency for Medical Research and Development, AMED (JP23fk0108639h0002). Research involving humans and/or animals: All procedures performed herein were in accordance with the Institutional Review Board (IRB) of the National Center for Global Health and Medicine on 10/31/2022 (IRB approval number NCGM-S-004548–00) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Informed consent: Informed consent was obtained from the patient included in the study., (© 2024. The Author(s), under exclusive licence to Japanese Society of Nephrology.)
- Published
- 2024
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