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Acute renal failure following snakebite.

K S Chugh, B K Aikat, B K Sharma

    The American Journal of Tropical Medicine and Hygiene
    |July 1, 1975
    PubMed
    Summary
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    Snakebite envenomation can cause acute renal failure through hemolysis and coagulation issues or direct kidney toxicity. Acute tubular necrosis cases recovered, while acute cortical necrosis cases were fatal.

    Area of Science:

    • Nephrology
    • Toxicology
    • Hematology

    Background:

    • Snakebite envenomation is a significant cause of acute renal failure (ARF) in many regions.
    • The mechanisms underlying ARF post-snakebite include intravascular hemolysis, disseminated intravascular coagulation (DIC), and direct nephrotoxicity.

    Purpose of the Study:

    • To investigate the clinical and histopathological features of acute renal failure following snakebite.
    • To determine the outcomes and prognostic factors in patients with snakebite-induced ARF.

    Main Methods:

    • Retrospective case series of eight patients with acute renal failure after snakebite.
    • Clinical data review, including laboratory findings and treatment modalities.
    • Histopathological examination of renal biopsies or autopsy tissues.

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    Main Results:

    • Six patients developed ARF due to intravascular hemolysis and DIC.
    • Two patients had ARF potentially from direct nephrotoxicity, one with mild DIC.
    • Histopathology revealed acute tubular necrosis (ATN) in 3 patients and acute symmetrical cortical necrosis (ACN) in 3 patients.
    • One patient with ATN showed tubular epithelial damage; two had no documented lesions.
    • All 5 patients with ATN recovered renal function (3 with dialysis, 2 with conservative management).
    • None of the 3 patients with ACN survived despite dialysis.

    Conclusions:

    • Snakebite-induced ARF has varied etiologies, including hemolysis, DIC, and direct nephrotoxicity.
    • Acute tubular necrosis carries a favorable prognosis with appropriate management, including dialysis.
    • Acute cortical necrosis is a severe complication with a high mortality rate, irrespective of dialysis.