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Snake-bite-induced acute renal failure in India.
1Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Kidney International
|March 1, 1989
Summary
Severe viper poisoning frequently causes acute renal failure through various mechanisms like bleeding and hemolysis. Further research is needed to pinpoint the exact causes and improve patient outcomes globally.
Area of Science:
- Nephrology
- Toxicology
- Pathophysiology
Background:
- Acute renal failure (ARF) is a significant complication in severe viper poisoning, affecting 5-30% of victims.
- The precise mechanisms underlying venom-induced ARF remain unclear, with multiple contributing factors.
- Viper venom triggers systemic abnormalities that predispose to kidney injury.
Observation:
- Clinical abnormalities include bleeding, hypotension, circulatory collapse, intravascular hemolysis, and disseminated intravascular coagulation.
- Direct venom cytotoxicity on renal tissue is suspected but not definitively proven.
- Severe hypocomplementemia is observed but its causal role in renal lesions is questioned.
Findings:
- Hypersensitivity reactions to venom or antivenom can occasionally lead to ARF.
- In sea snake envenomation, myonecrosis and myoglobinuria are key pathogenetic factors.
- Common renal lesions include acute tubular necrosis and cortical necrosis; rarer forms like glomerulonephritis and interstitial nephritis are also reported.
Implications:
- Understanding the diverse mechanisms of venom-induced ARF is crucial for developing targeted treatments.
- Further investigation into pathogenetic pathways may offer insights applicable to acute kidney injury from various causes.
- This knowledge can improve patient care for acute renal failure globally, particularly in regions with high snakebite incidence.