(B-234) Impact of Three Antimalarial Therapies on Renal Function in Nigerian Children with Uncomplicated Plasmodium Falciparum Infection

Background: Antimalarial therapy has been associated with renal function derangements, often attributed to drug-induced nephrotoxicity. However, it remains uncertain whether these changes persist following treatment completion.

Objectives: To investigate the impact of three antimalarial therapies—artemether-lumefantrine (AL), atovaquone-proguanil (A/P), and chloroquine (CQ)—on renal function in Nigerian children with uncomplicated Plasmodium falciparum infection.

Methods: This is a retrospective study. Data were analyzed from 128 case records of children aged 3–119 months who participated in two clinical trials conducted in Southwest Nigeria between 1998 and 2002. Changes in serum creatinine levels from baseline to the 28-day follow-up were compared among children treated with AL (n=73), A/P (n=32), and CQ (n=23). A general linear model (GLM) was employed for repeated measures analysis.

Results: The median age of the participants was 26 months, with 52% being female. Over 28 days, the AL group demonstrated a significant decrease in serum creatinine levels from baseline (mean difference: -0.2 mg/dL, 95% CI: 0.1–0.3, p=0.001). In contrast, the A/P and CQ groups showed non-significant increases (A/P: 1.16–1.20 mg/dL, p=0.480; CQ: 1.15–1.34 mg/dL, p=0.145). Overall, AL significantly improved renal function, whereas A/P and CQ had no notable impact.

Conclusions: Among the three antimalarial therapies studied, AL demonstrated superior renal function improvement in children, suggesting it as the preferred option for those with renal impairment. Further studies are recommended to confirm these findings and guide treatment decisions.