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 |
|---|---|---|---|
| with AKI (N = 13) | without AKI (N = 77) | ||
| 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