Glucose-6-phosphate dehydrogenase deficiency is associated with increased risk of acute kidney injury independent of hemolytic complications in children with severe malaria

Abstract

Acute kidney injury (AKI) is common and predicts mortality in severe malaria. Studies have reported an increased incidence of AKI in males with hemolytic features of severe malaria. Glucose-6-phosphate dehydrogenase (G6PD) deficiency, an X-linked enzymopathy, can induce hemolysis. We evaluated whether the G6PD African allele (A-) was associated with AKI in children with severe malaria. The prevalence of G6PD deficiency was 16.7% among hemizygous male children and 2.4% in female children. G6PD deficiency was associated with 2.56-fold odds of AKI (95% confidence interval, 1.33-4.93; P = .005), adjusting for age, sex, site, nutritional status, and features of hemolysis.