Clinical profile and outcome of Aki in snake bite patients

Vivek C Ganiger, Avinash Itagi, Deba Prasad Kar, Shiv Shankar Sharma

Abstract


Introduction: Snake bite is an important cause of Acute kidney injury (AKI), which contributes to 8%-45% of total AKI patients. There are number of published studies describing Acute Kidney Injury in Snake bite patients. However, there is a lack of recent data on AKI in Snake bite from India. The purpose of this study was to analyze the clinical profile and outcome AKI in Snake bite patients.
Materials and Methods: All AKI (Acute Kidney Injury) Patients due to snake bite were evaluated. Detail
clinical profile of AKI patients including history and physical examination were studied. Complete blood
count, renal function tests, Liver function tests, Urinalysis, Coagulation profile, total CPK, LDH, D-dimer
were done in all patients. Patients with persistent renal dysfunction even after of 3 weeks are advised
to undergo Contrast Enhanced Computed Tomography scan of KUB and/or renal biopsy. Demography,
clinical profile, causes of AKI, course in the hospital, management aspects and outcome were studied in
detail. Patients were followed up for 3 months to determine the recovery of renal function or progression
to chronic kidney disease.
Results: Among Two hundred twenty-one AKI patients (221), twenty-three patients were found to have AKI due to snake bite, with an incidence of 10.4%. Acute tubular necrosis was noted in 69.6% of the patients followed by Acute interstitial nephritis in 13% and renal cortical necrosis in 8.6%. 56.5% (13) of
the patients were dialysis dependent at time of admission. Among them, two patients were progressed to chronic kidney disease.
Conclusion: Oligoanuria was the main presenting complaint. Sepsis and Hypotension were present in more than 50% of the patients. The main reason for AKI in our patients was (ATN) Acute tubular necrosis. Mortality was observed in 8.7% of total AKI patients.

Keywords: Acute tubular necrosis, Snake bite, Renal cortical necrosis.


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