A 44-year-old man with severe P. falciparum malaria (parasitaemia 9%) is on IV artesunate. His initial creatinine was 110 µmol/L. On day 4, parasitaem...

Question

A 44-year-old man with severe P. falciparum malaria (parasitaemia 9%) is on IV artesunate. His initial creatinine was 110 µmol/L. On day 4, parasitaemia has cleared but his creatinine has risen to 310 µmol/L with oliguria. Which statement about acute kidney injury in severe malaria is correct?

Accepted Answer

AKI can develop or worsen after parasite clearance due to ongoing acute tubular necrosis from haemoglobin/myoglobin-mediated oxidative damage and microvascular injury

Answer

AKI only occurs during active parasitaemia and never after parasite clearance

Answer

AKI in malaria is exclusively pre-renal and responds to fluid resuscitation alone

Answer

AKI in malaria is always irreversible

Answer

Nephrotoxicity from artesunate is the most common cause of rising creatinine during treatment

uk-dtmh MCQ (SBA): AKI Pathophysiology in Severe Malaria

A 44-year-old man with severe P. falciparum malaria (parasitaemia 9%) is on IV artesunate. His initial creatinine was 110 µmol/L. On day 4, parasitaemia has cleared but his creatinine has risen to 310 µmol/L with oliguria. Which statement about acute kidney injury in severe malaria is correct?