Trial reportClinical infectious diseases : an official publication of the Infectious Diseases Society of America2018
Acetaminophen as a Renoprotective Adjunctive Treatment in Patients With Severe and Moderately Severe Falciparum Malaria: A Randomized, Controlled, Open-Label Trial.
Trial report in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 42 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Paracetamol Effect on Oxidative Stress and Renal Function in Severe Falciparum Malaria With Intravascular Haemolysis: A Randomised Controlled Clinical Trial
An MRI Ancillary Study of a Malaria Fever Randomized Controlled Trial (RCT)
Who cites it
42 citing papers in PubMed, 64 citations in OpenAlex.
- Trial
- Trial
- The Effect of Regularly Dosed Acetaminophen vs No Acetaminophen on Renal Function in Plasmodium knowlesi Malaria (PACKNOW): A Randomized, Controlled Trial.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022Trial
- Prediction of postoperative acute kidney injury in patients undergoing off-pump coronary artery bypass grafting: A machine learning model.Journal of anesthesia and translational medicine · 2026Article
- Population Pharmacokinetics and Pharmacodynamics of Paracetamol in Malaysian Patients With Plasmodium knowlesi Malaria.CPT: pharmacometrics & systems pharmacology · 2026Article
- Host-directed therapeutic strategies against apicomplexan parasites: targeting purinergic P2 receptors.Purinergic signalling · 2026Review
- Urinary carbonic anhydrase 1 excretion is a marker of hemolysis-triggering conditions suitable for point-of-care testing.Blood global hematology · 2026Article
- Article
- Malaria.The New England journal of medicine · 2025Review
- Acetaminophen and Clinical Outcomes in Sepsis: A Retrospective Propensity Score Analysis of the Ibuprofen in Sepsis Study.CHEST critical care · 2025Article
- CD8Frontiers in cellular and infection microbiology · 2025Article
- ISCCM Position Statement on the Management of Severe Malaria in Intensive Care Unit.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2024Article
- The malarial blood transcriptome: translational applications.Biochemical Society transactions · 2024Review
- Infections and Acute Kidney Injury: A Global Perspective.Seminars in nephrology · 2023Review
- Renin as a Biomarker of Acute Kidney Injury and Mortality in Children With Severe Malaria or Sickle Cell Disease.Cureus · 2023Article
- Article
- The kidney-brain pathogenic axis in severe falciparum malaria.Trends in parasitology · 2023Review
- Acetaminophen as Renoprotective Treatment in a Patient With Severe Malaria.Federal practitioner : for the health care professionals of the VA, DoD, and PHS · 2023Article
- Primaquine-induced Severe Hemolysis in the Absence of Concomitant Malaria: Effects on G6PD Activity and Renal Function.The American journal of tropical medicine and hygiene · 2023Article
- Transpulmonary generation of cell-free hemoglobin contributes to vascular dysfunction in pulmonary arterial hypertension via dysregulated clearance mechanisms.Pulmonary circulation · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
33 authors at 8 institutions in 7 countries.
Funding
Abstract
Background: Acute kidney injury independently predicts mortality in falciparum malaria. It is unknown whether acetaminophen's capacity to inhibit plasma hemoglobin-mediated oxidation is renoprotective in severe malaria. Methods: This phase 2, open-label, randomized controlled trial conducted at two hospitals in Bangladesh assessed effects on renal function, safety, pharmacokinetic (PK) properties and pharmacodynamic (PD) effects of acetaminophen. Febrile patients (>12 years) with severe falciparum malaria were randomly assigned to receive acetaminophen (1 g 6-hourly for 72 hours) or no acetaminophen, in addition to intravenous artesunate. Primary outcome was the proportional change in creatinine after 72 hours stratified by median plasma hemoglobin. Results: Between 2012 and 2014, 62 patients were randomly assigned to receive acetaminophen (n = 31) or no acetaminophen (n = 31). Median (interquartile range) reduction in creatinine after 72 hours was 23% (37% to 18%) in patients assigned to acetaminophen, versus 14% (29% to 0%) in patients assigned to no acetaminophen (P = .043). This difference in reduction was 37% (48% to 22%) versus 14% (30% to -71%) in patients with hemoglobin ≥45000 ng/mL (P = .010). The proportion with progressing kidney injury was higher among controls (subdistribution hazard ratio, 3.0; 95% confidence interval, 1.1 to 8.5; P = .034). PK-PD analyses showed that higher exposure to acetaminophen increased the probability of creatinine improvement. No patient fulfilled Hy's law for hepatotoxicity. Conclusions: In this proof-of-principle study, acetaminophen showed renoprotection without evidence of safety concerns in patients with severe falciparum malaria, particularly in those with prominent intravascular hemolysis. Clinical Trials Registration: NCT01641289.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.