Long-Term Renal Outcome of Snake Bite and Acute Kidney Injury: A Single-Center Experience

Waikhom, Rajesh; Sircar, Dipankar; Patil, Kishor; Bennikal, Mahesh; Gupta, Sanjoy Das; Pandey, Rajendra

doi:10.3109/0886022x.2011.647297

Cited by 27 publications

(31 citation statements)

References 14 publications

(14 reference statements)

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“…Patients with patchy cortical necrosis show delayed and partial recovery of renal function but those with diffuse cortical necrosis require regular maintenance dialysis and eventual renal transplantation[41]. RCN has been observed in 27 (24%) kidney biopsies out of total of 112 kidney biopsies carried out in patients of snake bite-induced AKI from India and Pakistan[9,28,39,40,42,43]. None had RCN on biopsy in two studies[39,40].…”

Section: Discussionmentioning

confidence: 99%

“…Further, long-term outcome of snake bite-induced severe dialysis-requiring AKI is not benign with a significant percentage of patients continuing to have features of persistent renal damage in the form of renal dysfunction, proteinuria, or hypertension[43]. CKD is an outcome of severe AKI following snake envenoming probably predicted by the length of RRT[44].…”

Section: Discussionmentioning

confidence: 99%

“…The special investigations like complete coagulation profile as evidence for DIC were not done in all patients, identification of snake species and ELISA test to identify the snake venom are the other lacunae. Finally, we also could not assess long term residual injury in these cases of snake envenomation, although this is being increasingly recognized[43,45]. …”

Section: Discussionmentioning

confidence: 99%

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Clinicopathological spectrum of snake bite-induced acute kidney injury from India

Vikrant¹,

Jaryal²,

Parashar³

2017

WJN

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AIMTo study the clinico-pathological spectrum of snake bite-induced acute kidney injury (AKI).METHODSA retrospective study of patients admitted at Indira Gandhi Medical College Hospital, Shimla with snake bite-induced AKI from July 2003 to June 2016. Medical records were evaluated for patient’s information on demographic, clinical characteristics, complications and outcome. Outcomes of duration of hospital stay, requirement for intensive care unit support, treatment with dialysis, survival and mortality were analyzed. The survival and non survival groups were compared to see the difference in the demographic factors, clinical characteristics, laboratory results, and complications. In patients subjected to kidney biopsy, the findings of histopathological examination of the kidney biopsies were also analyzed.RESULTSOne hundred and twenty-one patients were diagnosed with snake bite-induced AKI. Mean age was 42.2 ± 15.1 years and majority (58%) were women. Clinical details were available in 88 patients. The mean duration of arrival at hospital was 3.4 ± 3.7 d with a range of 1 to 30 d. Eighty percent had oliguria and 55% had history of having passed red or brown colored urine. Coagulation defect was seen in 89% patients. The hematological and biochemical laboratory abnormalities were: Anemia (80.7%), leukocytosis (75%), thrombocytopenia (47.7%), hyperkalemia (25%), severe metabolic acidosis (39.8%), hepatic dysfunction (40.9%), hemolysis (85.2%) and rhabdomyolysis (68.2%). Main complications were: Gastrointestinal bleed (12.5%), seizure/encephalopathy (10.2%), hypertension, pneumonia/acute respiratory distress syndrome (ARDS) and disseminated intravascular coagulation (9.1% each), hypotension and multi organ failure (MOF) (4.5% each). Eighty-two percent patients required renal replacement therapy. One hundred and ten (90.9%) patient survived and 11 (9.1%) patients died. As compared to the survival group, the white blood cell count (P = 0.023) and bilirubin levels (P = 0.006) were significant higher and albumin levels were significantly lower (0.005) in patients who died. The proportion of patients with pneumonia/ARDS (P = 0.001), seizure/encephalopathy (P = 0.005), MOF (P = 0.05) and need for intensive care unit support (0.001) was significantly higher and duration of hospital stay was significantly shorter (P = 0.012) in patients who died. Kidney biopsy was done in total of 22 patients. Predominant lesion on kidney biopsy was acute tubular necrosis (ATN) in 20 (91%) cases. In 11 cases had severe ATN and in other nine (41%) cases kidney biopsy showed features of ATN associated with mild to moderate acute interstitial nephritis (AIN). One patient only had moderate AIN and one had patchy renal cortical necrosis (RCN).CONCLUSIONAKI due to snake bite is severe and a high proportion requires renal replacement therapy. On renal histology ATN and AIN are common, RCN is rare.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Clinicopathological spectrum of snake bite-induced acute kidney injury from India

Vikrant¹,

Jaryal²,

Parashar³

2017

WJN

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“…The clinical significance of these findings is still unclear, but abnormalities occurring both in the upper and lower limbs indicate a systemic rather than a local phenomenon. There have been reports that suggest the development of chronic kidney disease in victims of Russell's viper bites who had acute kidney injury at the time of envenoming at least 12 months [20] and a mean 45 months [21] previously. Major limitations of these studies are the presence of co-morbidities such as diabetes and hypertension, and the failure to rule out pre-existing renal disease.…”

Section: Disability In Survivors: the 'Hidden' Burdenmentioning

confidence: 99%

Snakebite: the true disease burden has yet to be determined

Silva¹,

Kasturiratne²,

Pathmeswaran

et al. 2013

Ceylon Med. J.

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Snakebite: the true disease burden has yet to be determined Venomous snakes are a significant cause of morbidity and mortality, particularly in tropical and subtropical countries in Africa, Asia, Oceania and Latin America. Most snake bites occur in the rural tropics, and result in a high medical and economic toll. The reasons include poor access to [often suboptimal] health services, scarcity of effective and safe antivenom (AVS), survival with disability, and the economic impact of disabled young victims [1]. Despite this, snakebite has not received due attention and the main reason for this is the paucity of sound epidemiological data with which to make the case. Difficulties in obtaining accurate data on snakebiteSnakebite mainly occurs in the poorest countries of the world that are least able to deal with the problem [2]. Data on snakebite are based mainly on hospital returns or incomplete central databases. Bites and associated mortality are underreported because many victims do not seek treatment in government health facilities, preferring traditional treatments. Studies from rural Nigeria and Kenya have reported that only 8.5% and 27% of snakebite victims, respectively, sought hospital treatment [3,4]. In rural Bangladesh only 3% of victims went directly to a medical doctor or hospital [5].Two qualitative studies, investigating beliefs regarding snakebite and their influence on health seeking behavior in Sri Lanka found that people living in four rural communities believed that Ayurvedic treatment was effective for snakebite [6,7]. Common misconceptions regarding hospital treatment were based mainly on misinformation regarding AVS therapy. Traditional healers were respected and perceived to be able to cure snakebite, and although many people may finally seek treatment in a hospital, they would first consult a traditional healer. Similar situations are likely to be common to many countries where health-seeking behaviour, health beliefs and access to health care are not optimal.The incidence of snakebite varies seasonally (e.g. high during agricultural activity) and geographically. Studies from India and Bangladesh have clearly shown increased rates of bites during periods of high rainfall and flooding [5,8]. Therefore, data obtained during seasonal surveys would not represent true annual incidence. Marked regional variations in incident snakebite deaths have been demonstrated in a recent nationwide survey conducted in India [8].This type of geographical variation in snake bites is seen even in small countries like Sri Lanka [9]. In the face of such heterogeneity, localised surveys will not reflect true national or regional values [3].Estimates of snakebite mortality are based mainly on hospital data, because other recording systems are unavailable or unreliable in most

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“…Renal kaynaklı ABH nedenleri arasında toksik nefropati de yer almaktadır. Toksik nefropati; ilaçlar (antibiyotikler, nonsteroid antienflamatuvar ilaçlar, kemoterapötikler vs), organik çözücüler (toluen, etilen glikol, radyokontrast maddeler, endojen toksinler ve zehirler (akrep, yılan sokması) nedeniyle gelişebilir (1)(2)(3)(4)(5).…”

Section: Introductionunclassified

Acute Kidney Injury After Scorpion Sting

Güngör¹,

Ganidagli²,

Törün³

et al. 2017

Turk Neph Dial Transpl

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ÖzAkrep sokması olguları ülkemizde çoğunlukla güney illerde görülür. Akrep toksini nörotoksik, kardiyotoksik ve nefrotoksik içerik taşır. Nefropati gelişimi akrep sokmasının nadir görülen bir komplikasyonudur. 27 yaşında erkek hasta, akrep sokması sonrası gelişen akut böbrek hasarıyla başvurmuş, etiyoloji muhtemelen hipovolemi ile ilişkilendirilmiştir.anahtar sözcükler: Akrep, Isırık, Akut böbrek hasarı ABSTRACTScorpion sting cases are mostly seen in the southern provinces in our country. Scorpion venom might comprise neurotoxic, cardiotoxic and even nephrotoxic contents. Occurrence of nephropathy is a rare complication of scorpion sting. A 27-year-old male was admitted with acute kidney injury after scorpion sting. The etiology was probably associated with hypovolemia.

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Long-Term Renal Outcome of Snake Bite and Acute Kidney Injury: A Single-Center Experience

Cited by 27 publications

References 14 publications

Clinicopathological spectrum of snake bite-induced acute kidney injury from India

Clinicopathological spectrum of snake bite-induced acute kidney injury from India

Snakebite: the true disease burden has yet to be determined

Acute Kidney Injury After Scorpion Sting

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