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. 2013 Oct;5(10):594-9.
doi: 10.4103/1947-2714.120795.

Clinical predictors of acute kidney injury following snake bite envenomation

Mrudul V Dharod  1 , Tushar B Patil  1 , Archana S Deshpande  1 , Ragini V Gulhane  1 , Mangesh B Patil  1 , Yogendra V Bansod  1
Affiliations

Clinical predictors of acute kidney injury following snake bite envenomation

Mrudul V Dharod et al. N Am J Med Sci. 2013 Oct.

Abstract

Background: Snake bite envenomation is a major public health concern in developing countries. Acute kidney injury (AKI) is as important cause of mortality in patients with vasculotoxic snake bite.

Aims: This study was to evaluate the clinical profile of snake bite patients and to determine the predictors of developing AKI following snake bite.

Materials and methods: Two hundred and eighty-one patients with snake envenomation were included. Eighty-seven patients developed AKI (Group A) and 194 (Group B) did not. History, examination findings and investigations results were recorded and compared between the two groups.

Results: In group A, 61 (70.11%) patients were male and in group B, 117 (60.30%) patients were male. Out of 281 patients, 232 had cellulitis, 113 had bleeding tendencies, 87 had oliguria, 76 had neuroparalysis, and 23 had hypotension at presentation. After multivariate analysis, bite to hospital time (P = 0.016), hypotension (P = 0.000), albuminuria (P = 0.000), bleeding time (P = 0.000), prothrombin time (P = 0.000), hemoglobin (P = 0.000) and total bilirubin (P = 0.010) were significant independent predictors of AKI.

Conclusions: AKI developed in 30.96% of patients with snake bite, leading to mortality in 39.08% patients. Factors associated with AKI are bite to hospital time, hypotension, albuminuria, prolonged bleeding time, prolonged prothrombin time, low hemoglobin and a high total bilirubin.

Keywords: Acute kidney injury; Bite to hospital time; Coagulopathy; Envenomation; Hemolysis; Snake bite.

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Conflict of interest statement

Conflict of Interest: None declared.

References

    1. Kasturiratne A, Wickremasinghe AR, de Silva N, Gunawardena NK, Pathmeswaran A, Premaratna R, et al. The global burden of snakebite: A literature analysis and modelling based on regional estimates of envenoming and deaths. PLoS Med. 2008;5:e218. - PMC - PubMed
    1. Monteiro FN, Kanchan T, Bhagavath P, Kumar GP, Menezes RG, Yoganarasimha K. Clinico-epidemiological features of viper bite envenomation: A study from Manipal, South India. Singapore Med J. 2012;53:203–7. - PubMed
    1. Warrell DA. Epidemiology of snake-bite in South-East Asia Region. In: Warrell DA, editor. Guidelines for the management of snakebite. New Delhi, India: WHO regional office for Southeast Asia; 2010. pp. 35–45.
    1. Srimannarayana J, Dutta TK, Sahai A, Badrinath S. Rational use of anti-snake venom (ASV): Trial of various regimens in hemotoxic snake envenomation. J Assoc Physicians India. 2004;52:788–93. - PubMed
    1. Lavonas EJ, Tomaszewski CA, Ford MD, Rouse AM, Kerns WP., 2nd Severe puff adder (Bitis arietans) envenomation with coagulopathy. J Toxicol Clin Toxicol. 2002;40:911–8. - PubMed