Critical care
Does malaria-related kidney injury leave lasting brain and kidney harm?
Open access · cc by · source: Europe PMC
In 479 Ugandan children with severe malaria, KDIGO AKI (35%) tracked higher death (aHR 2.30), more cognitive impairment at 2 years (aOR 3.03), and more CKD (7.6% vs 2.8%).
How this study connects
Role on claims
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The two-year cognitive gap is larger in relative terms than the one-week gap.
The consequences of critical illness extend years past discharge. Among patients with acute kidney injury, in-hospital death was 11.9% against 4.2%, cognitive impairment was 37.3% against 13.5% at one week (aOR 2.31) and 13.0% against 3.4% at two years (aOR 3.03), with chronic kidney disease at one year 7.6% against 2.8%.
Evidence for the claim as stated.
Study at a glance
- Design
- Cohort — Prospective Ugandan pediatric cohort of cerebral malaria and severe malarial anemia vs community children; AKI/CKD defined retrospectively with KDIGO; cognition followed to 2 years.
- N
- N=652 · CM 260, SMA 219, community children 173; ages 1.5–12 years.
- Population
- Ugandan children 1.5–12 years with cerebral malaria or severe malarial anemia, plus community controls.
- Outcome
- AKI prevalence, in-hospital and post-discharge death, neurocognitive impairment, and CKD at follow-up.
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Inspect source passages
Does malaria-related kidney injury leave lasting brain and kidney harm?
These passages occur verbatim in the stored paper text. They support the points listed below; they do not verify every statement in the explanation.
AKI prevalence was 35.1% (25.1% SMA, 43.5% CM).
The prevalence of AKI was 35.1%, ranging from 25.1% in SMA to 43.5% in CM.
All-cause death aHR with AKI was 2.30 (95% CI 1.21–4.35).
all-cause adjusted hazard ratio of 2.30 (95% CI 1.21, 4.35)
Key findings
AKI prevalence was 35.1% (25.1% SMA; 43.5% CM). In-hospital death was 11.9% vs 4.2% without AKI; post-discharge death 4.7% vs 1.3% (all-cause aHR 2.30). Cognitive impairment was 37.3% vs 13.5% at 1 week (aOR 2.31) and 13.0% vs 3.4% at 2 years (aOR 3.03). CKD at 1 year: 7.6% vs 2.8% (OR 2.81).
Methodology
Enrolled children with cerebral malaria (n=260) or severe malarial anemia (n=219) and community children (n=173), retrospectively applied KDIGO AKI/CKD definitions, and tested cognition with Mullen (<5 years) or K-ABC (≥5) through 2 years.
Limitations
A single admission creatinine and community-estimated baselines likely underestimate AKI and cannot prove AKI itself caused later cognitive loss versus overall severe illness.
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