Prognostic factors in malaria patients with acute kidney injury: a systematic review and meta analysis

Clinical Snapshot

Key Findings

• P Value: All significant factors p < 0.05, strongest associations p < 0.001

• Effect Size: Multiple prognostic factors identified with ORs ranging from 3.41 to 30.35

• Primary Outcome: Mortality in malaria patients with acute kidney injury

• Nnt Or Sensitivity: Ventilator requirement strongest predictor (OR: 30.35), followed by respiratory distress (OR: 18.50) and hypotension (OR: 18.23)

• Confidence Interval: Not reported in abstract

Clinical Application

Prognostic factors are readily identifiable in clinical practice Relevant for travel medicine clinics, infectious disease specialists, and emergency departments managing returned travellers; limited direct applicability due to low local malaria incidence Malaria patients with AKI in endemic areas and travel medicine settings

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, p < 0.001), neurological involvement (OR: 12.83, p < 0.001), disseminated intravascular coagulation (OR: 12.00, p < 0.001), hypotension (OR: 18.23, p < 0.001), oliguria (OR: 3.41, p = 0.002), ventilator requirement (OR: 30.35, p < 0.001), leukocytosis (OR: 4.87, p = 0.003), hyponatremia (OR: 3.67, p = 0.048), acidosis (OR: 4.88, p < 0.001), hyperkalemia (OR: 3.99, p < 0.001), and jaundice (OR: 5.03, p = 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.

References

1. 1.Tear, A. A., Fauziah, N., Riswari, S. F., Purba, A. R., Akhlaq, M. M., & Susanto, N. H. (2026). Prognostic factors in malaria patients with acute kidney injury: a systematic review and meta analysis. Renal Failure. https://doi.org/10.1080/0886022X.2026.2665050