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Clinical and laboratory abnormalities linked to higher mortality in malaria patients with acute kidney injury

Clinical and laboratory abnormalities linked to higher mortality in malaria patients with acute…
Photo by Bioscience Image Library by Fayette Reynolds / Unsplash
Key Takeaway
Recognize that specific clinical and laboratory abnormalities associate with higher mortality in malaria patients with acute kidney injury.

This systematic review and meta-analysis examined the association between specific clinical or laboratory abnormalities and mortality among patients with malaria and acute kidney injury. The study pooled data from multiple sources to assess how factors like respiratory distress, disseminated intravascular coagulation, and electrolyte imbalances relate to death rates in this vulnerable population.

The analysis identified that several abnormalities, including ventilator requirement, hypotension, and neurological involvement, showed a strong positive association with mortality. Other findings included links between acidosis, hyperkalemia, jaundice, and leukocytosis with higher mortality risk. These results highlight the severity of these complications in the context of combined malaria and kidney injury.

The authors note that the study design limits the ability to infer causation, as the data reflect observed associations rather than causal mechanisms. Additionally, the review did not report on safety or tolerability of interventions. The practice relevance emphasizes the need for clinicians to maintain heightened awareness and vigilance when managing patients presenting with these specific clinical and laboratory markers.

Study Details

Study typeMeta analysis
Sample sizen = 1,104
EvidenceLevel 1
PublishedDec 2026
View Original Abstract ↓
This systematic review and meta-analysis aims to evaluate the predictors of mortality in malaria patients with AKI. Studies were searched in PubMed, Scopus, Ebsco, and ScienceDirect. We included observational studies that showed the association between clinical or laboratory abnormalities and mortality, reported in odds ratio. The quality of each study was assessed using the Newcastle-Ottawa Scale. Meta-analysis was performed using R. Sixteen studies with 1,104 patients were analyzed. Factors significantly associated with mortality were respiratory distress syndrome (OR: 18.50,  < 0.001), neurological involvement (OR: 12.83,  < 0.001), disseminated intravascular coagulation (OR: 12.00,  < 0.001), hypotension (OR: 18.23,  < 0.001), oliguria (OR: 3.41,  = 0.002), ventilator requirement (OR: 30.35,  < 0.001), leukocytosis (OR: 4.87,  = 0.003), hyponatremia (OR: 3.67,  = 0.048), acidosis (OR: 4.88,  < 0.001), hyperkalemia (OR: 3.99,  < 0.001), and jaundice (OR: 5.03,  = 0.001). ARDS, neurological involvement, DIC, hypotension, oliguria, ventilator requirement, leukocytosis, hyponatremia, acidosis, hyperkalemia, and jaundice were associated with mortality in malaria patients with AKI. The findings underscored the importance of heightened awareness and vigilance in managing patients with these conditions.
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