Evaluation of Nephrotoxic and Hepatotoxic Potential of Artesunate in Malaria Patients

Aim: To evaluate the nephrotoxic and hepatotoxic potentials of artesunate in humans.

Place and Duration of Study: Department of Biochemistry, Michael Okpara University of Agriculture, Umudike, Abia State, Nigeria, between November and December 2019.

Methodology: 70 blood samples were collected from 35 normal individuals (control group), and 35 malaria patients treated with parenteral artesunate (treatment group). These were analyzed for biochemical parameters, including blood urea nitrogen (BUN), creatinine, total bilirubin, aspartate transaminase (AST), alanine transaminase (ALT), and alkaline phosphatase (ALP). The treatment group was further regrouped according to gender (19 males and 16 females), age (20 patients aged 20-29 and 15 patients aged 30-40 years) and duration of treatment (29 patients on 3rd or 4th day and 6 patients on 5th or 6th day of treatment). Biochemical tests were carried out using standard Randox test kits. One-way ANOVA was done on the parameters using statistical package for social sciences (SPSS), and comparisons were made.

Results: Compared to control group, the treatment group showed significant increases (p<0.05) in BUN (15.89+1.30 against 11.69+0.62), Creatinine (0.96+0.62 against 0.82+0.03) and AST (22.14+2.45 against 16.66+0.85), a non-significant increase (p 0.05) in ALT (26.57+3.18 against 21.66+2.56) and ALP (85.31+4.06 against 77.54+3.09) and a non-significant decrease (p 0.05) in total bilirubin (0.59+0.06 against 0.65+0.06). However, all parameters examined were within the normal ranges. There was no significant relationship found in any parameter in a comparison of gender, age and duration of treatment.

Conclusion: Since all parameters examined were in the normal ranges, administration of artesunate in the recommended dosage and the right duration may not have any significant toxic effect on the kidney and liver. However, further studies may be necessary to ascertain if the observed elevations could be attributed wholly to artesunate or other medications taken by the malaria patients.