4.8 Review

Immunopathology of Acute Kidney Injury in Severe Malaria

Journal

FRONTIERS IN IMMUNOLOGY
Volume 12, Issue -, Pages -

Publisher

FRONTIERS MEDIA SA
DOI: 10.3389/fimmu.2021.651739

Keywords

malaria; inflammation; acute kidney injury (AKI); immune response; hemolysis; P; falciparum; kidney injury

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Funding

  1. National Institute for Health Research (NIHR) Imperial Biomedical Research Centre (BRC)
  2. Imperial College Research Fellowship

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Acute kidney injury is a common complication of severe malaria and an independent risk factor for death. Different aspects of malaria pathology interact to amplify the damaging effects of the host inflammatory response on the kidneys.
Acute kidney injury (AKI) is a common feature of severe malaria, and an independent risk factor for death. Previous research has suggested that an overactivation of the host inflammatory response is at least partly involved in mediating the kidney damage observed in P. falciparum patients with AKI, however the exact pathophysiology of AKI in severe malaria remains unknown. The purpose of this mini-review is to describe how different aspects of malaria pathology, including parasite sequestration, microvascular obstruction and extensive intravascular hemolysis, may interact with each other and contribute to the development of AKI in severe malaria, by amplifying the damaging effects of the host inflammatory response. Here, we highlight the importance of considering how the systemic effects and multi-organ involvement of malaria are intertwined with the localized effects on the kidney.

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