G6PD Deficiency is Associated with an Increased Risk of Acute Kidney Injury Independent of Hemolytic Complications in Children with Severe Malaria

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 SM. 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 males and 2.4% in females. G6PD deficiency was associated with 2.56-fold odds of AKI (95% CI, 1.33 to 4.93, p=0.005), adjusting for age, sex, site, nutritional status, and features of hemolysis.