The contribution of malaria to overall hospital admissions for AKI varies from 2% to 39%2 Majority of the cases were due to severe falciparum malaria, however recently few cases of plasmodium vivax causing renal dysfunction have been reported. Acute kidney injury is an important cause of morbidity and mortality in severe falciparum malaria. All patients were treated with inj Artesunate 2.4 mg/kg b/w at 0 hrs., 12 hrs., 24 hrs. then once daily for 7 days or continued until they were able to tolerate drugs orally. Then ACT (artemether plus lumefanterne or Artesunate plus sulfadoxine-pyrimethamine) was given orally for a course of 3 days. Supportive treatments such as fluid replacement, urine output and plasma glucose were monitored closely during the period of admission. Patients with convulsion were treated with inj phenytoin 100 mg i.v 8hrly till they were able to take oral phenytoin with the same dose. Group A patients had mean urine output of 349m1112hrs. This group of majority were oliguric fulfilling failure criteria of RIFLE. Only 3 patients of group B were oliguric and hence the mean urine output of group was in nonoliguric range. Group C patients were without complications. With the use of serum cystatin C as a early renal injury marker, early recognition of renal dysfunction and with prompt antimalarial therapy, judicious fluid management and avoidance of nephrotoxic drugs, further impairment in renal function can be reduced.