Acidosis and acute kidney injury in severe malaria

Malaria Journal

Table 2 Plasma and urine concentrations of organic acids detected in patients with severe malaria with or without acute kidney injury (AKI)

Characteristics	Severe malaria	Severe malaria	p value
Characteristics	with AKI (N = 13)	without AKI (N = 77)	p value
Plasma concentration (μmol/l)^a
LA	6406 (4816–8520)	4335 (3760–4998)	0.066
αHBA	142 (107–188)	115 (102–131)	0.348
βHBA	178 (133–238)	133 (120–148)	0.043
pHPLA	33.8 (22.5–50.7)	7.88 (7.36–8.45)	< 0.001
Urine creatinine adjusted concentrations (μmol/mmol CrCl)^{a, b}
LA	50.7 (30.4–84.5)	7.55 (5.78–9.86)	< 0.001
αHBA	1.33 (0.86–2.06)	0.90 (0.66–1.22)	0.577
βHBA	5.94 (4.52–7.80)	2.22 (1.87–2.64)	< 0.001
pHPLA	8.80 (6.17–12.5)	1.04 (0.82–1.33)	< 0.001
MMA	0.11 (0.07–0.17)	0.15 (0.12–0.18)	0.245
EMA	0.16 (0.09–0.25)	0.22 (0.18–0.27)	0.232
αKGA	7.29 (6.28–8.46)	2.03 (1.76–2.33)	< 0.001
LA	800 (451–1420)	527 (400–696)	0.871
αHBA	21.0 (13.7–32.3)	67.0 (51.8–86.8)	0.019
βHBA	101 (86.0–120)	172 (152–194)	0.012
pHPLA	139 (102–189)	67.6 (53.6–85.2)	0.019
MMA	3.21 (2.59–3.98)	11.2 (9.38–13.4)	0.032
EMA	3.58 (2.42–5.30)	15.4 (12.4–19.1)	0.049
αKGA	242 (213–275)	218 (201–237)	0.197

For plasma specimens, undetectable concentrations were treated as half the lower limit of detection to allow inclusion in intergroup comparisons. For creatinine-corrected urine concentrations, undetectable values were treated as half the lowest value calculated from a detectable specimen. Values are geometric mean (95% CI)
GCS, Glasgow Coma Scale; geo mean, geometric mean; Hb, haemoglobin; PfHRP2, Plasmodium falciparum histidine-rich protein 2; UD, undetectable; LA, lactic acid; HPLA, hydroxyphenyllactic acid; α-HBA, α-hydroxybutyric acid; β-HBA, β-hydroxybutyric acid; EMA, ethylmalonic acid; MMA, methylmalonic acid; α-KGA, α-ketoglutaric acid; CrCl. creatinine clearance
^aFor all plasma specimens, EMA, MMA, α-KGA were assayed but undetectable
^bUrine creatinine-adjusted concentrations were corrected as described in the “Methods” section

ISSN: 1475-2875