RENAL-FUNCTION IN ACUTE FALCIPARUM-MALARIA

Renal function was assessed in 40 children during the acute illness an d after recovery from falciparum malaria. Creatinine clearance was sig nificantly lower during the acute illness than after recovery. Six of 18 children with impaired creatinine clearance (<50 ml/min/1.73 m(2)) had evidence of acute tubular dysfunction. Hyponatraemia occurred in 1 2.5% during the acute phase. Fractional sodium excretion was raised in 27% during the acute illness and continuing sodium wastage occurred i n 17% after recovery. Plasma potassium was significantly higher and fr actional potassium excretion (Fe-K) significantly lower during the acu te illness than after recovery. There was a positive correlation betwe en Fq(Na) and Fe, both during and after recovery from the illness but they did not exactly mirror each other in every individual. Urine sodi um:potassium ratios were similar during and after recovery from the il lness and was related to Fe,,. Fractional glucose excretion was zero. Mild proteinuria occurred in 40% during the acute illness but were not related to creatinine clearance, body temperature at presentation, or peripheral parasite density. Proteinuria was absent after recovery. A cute intrinsic renal impairment during apparently 'uncomplicated' paru m malaria in children.