Acute Renal Failure in Plasmodium falciparum Malaria

Two patients with renal failure due to heavy infection withPlasmodium falciparumwere successfully treated by peritoneal dialysis. Rapid clinical deterioration precluded safe transfer to a hemodialysis facility. The efficiency of peritoneal dialysis, although less than in other forms of renal failure, was sufficient to control the clinical and biochemical manifestations of renal failure. Quinine in combination with other antimalarial drugs was successful in doses less than usually employed for the chloroquine-resistant species of southeast Asia. No accumulation of quinine occurred in the one patient studied. However, a reduced dosage should be employed under these circumstances.