Snakebite Nephrotoxicity in Asia

Kanjanabuch, Talerngsak; Sitprija, Visith

doi:10.1016/j.semnephrol.2008.04.005

Cited by 77 publications

(97 citation statements)

References 49 publications

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“…An added value of uIgG in selectivity of proteinuria was also described in dogs with different types of nephropaties (Maddens et al, , 2011Vinge et al, 2010;Smets et al, 2012;Nabity et al, 2012). Elevation of both these markers of glomerular injury in this study also correlates well with described venom-induced histopathological lesions in kidneys of humans, dogs and rats (Rehan et al, 1986;Boer-Lima et al, 2002;Kanjanabuch and Sitprija, 2008;Mello et al, 2010).…”

Section: Discussionsupporting

confidence: 82%

“…Similar findings were reported in human snake victims in which the incidence of proteinuria usually resolved after clinical improvement of patients (Sitprija, 2006;Kanjanabuch and Sitprija, 2008). Rats injected with viperid venom also demonstrated a significant decline in proteinuria 48 h post-injection (Boer-Lima et al, 2002).…”

Section: Discussionsupporting

confidence: 81%

“…Tubular necrosis is suspected to be a frequent cause of acute renal failure in human victims of snake envenomation. Aside of this, several other tubular pathologies were also described after evenomation, namely infiltration of tubuli with different inflammatory cells, tubular interstitial lesions and oedema (Kanjanabuch and Sitprija, 2008). Furthermore, the combined elevation of two urinary markers of different molecular weight, namely the HMW IgG and the LMW RBP, as observed in this study, was also reported to be an excellent prognostic marker for ongoing renal injury in humans (Bazzi et al, 2001).…”

Section: Discussionsupporting

confidence: 70%

“…As a highly vascularised organ and also as a major elimination route of the snake venom, human and animal kidneys are very susceptible to nephrotoxic effects of envenomation (Sitprija, 2006;Kanjanabuch and Sitprija, 2008;Mello et al, 2010). Kidney injury after envenomation in humans, dogs and rats was reported to be caused either by a direct action of venom or an indirect action through inflammatory mediators, and nephrotoxic effects of myo-and haemoglobin, hypovolemia, disseminated intravascular coagulopathy (DIC) and renal ischemia (Sitprija, 2006;Mello et al, 2010;Goddard et al, 2011;Jacoby-Alner et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

“…The most commonly observed clinical manifestations of renal abnormalities after snake envenomation in humans and dogs are acute kidney injury (AKI), proteinuria and hematuria (Sitprija, 2006;Kanjanabuch and Sitprija, 2008;Goddard et al, 2011) The majority of studies and reports of snake envenomation in dogs have focused on routine serum analyses and only to some extent on urinalysis (Heller et al, 2007;Lervik et al, 2010;Gilliam and Brunker, 2011;Sutton et al, 2011). Nevertheless, these parameters are nonspecific and insensitive as they are only altered at the point when about 50 -75% of renal function is already lost (Finco, 1997).…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of snake envenomation-induced renal dysfunction in dogs using early urinary biomarkers of nephrotoxicity

Hrovat

Schoeman

Laat

et al. 2013

The Veterinary Journal

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Renal dysfunction in dogs envenomed by snakes has mostly been evaluated using routine serum and urine renal markers. Generally, these are not able to detect the renal damage at an early stage and their sensitivity is affected by hemolysis, hematuria and pigmenturia. Selective use of urinary biomarkers can provide early information on severity and stage of renal injury caused by nephrotoxic substances before major decline in renal function occurs. Therefore, the aim of this study was to evaluate venom-induced renal damage using urinary markers of glomerular (urinary albumin (uAlb), immunoglubin G (IgG) and Creactive protein (uCRP)) and proximal tubular dysfunction (urinary retinol binding protein (uRBP)) and compare these markers with routine renal markers (serum urea (BUN) and creatinine (sCr), urinary specific gravity (USG) and urinary protein to creatinine ratio (UPC)).Nineteen dogs envenomed by either neurotoxic or cytotoxic snakes and ten clinically healthy dogs were included in this study. Urinary markers were measured using previously validated commercially available ELISA kits. Among measured routine renal markers a significant difference between snake -envenomed and healthy dogs was noted only in UPC, but in the presence of hematuria and hemoglobinuria, differentiation between prerenal and renal proteinuria was not possible. The urinary biomarkers uAlb, uIgG and uRBP in snakeenvenomed dogs were significantly increased (P<0.05) when compared to healthy dogs at admission, whereas 24 h after envenomation only uCRP was significantly elevated. Using urinary /markers, results of this study showed that snake venom evokes renal dysfunction at the glomerular and tubular region of the nephron.

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