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Acute kidney injury due to multiple Hymenoptera stings-a clinicopathological study

Sanjay Vikrant1, Anupam Parashar2

  • 1Department of Nephrology, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India.

Clinical Kidney Journal
|January 18, 2018
PubMed
Abstract

Insights

Acute kidney injury from multiple Hymenoptera stings is severe, often requiring dialysis and carrying a high mortality risk. Renal histology commonly shows acute tubular necrosis (ATN) and acute interstitial nephritis (AIN).

Area of Science:

  • Nephrology
  • Toxicology
  • Internal Medicine

Background:

  • Acute kidney injury (AKI) following multiple Hymenoptera stings is a recognized but infrequent clinical occurrence.
  • This study investigates the clinicopathological characteristics of AKI resulting from Hymenoptera envenomation.

Purpose of the Study:

  • To analyze the spectrum of AKI in patients with multiple Hymenoptera stings.
  • To identify risk factors for mortality and describe renal histopathological findings.

Main Methods:

  • Retrospective analysis of 35 patients diagnosed with AKI due to multiple Hymenoptera stings between July 2003 and June 2016.
  • Review of clinicopathological data, laboratory abnormalities, complications, treatment (including dialysis), and renal biopsy findings.

Main Results:

  • The majority of patients (60%) were male, with a mean age of 44.7 years. Common laboratory findings included anemia (97.1%), hyperkalemia (68.6%), hepatic dysfunction (74.3%), and rhabdomyolysis (62.9%).
  • Significant complications included acute respiratory distress syndrome (ARDS) and encephalopathy (11.4% each). 83% of patients required dialysis, and the mortality rate was 29%.
  • Renal biopsies in survivors revealed acute tubular necrosis (ATN) in 77% and acute interstitial nephritis (AIN) in 30.8% or solely AIN in 23% of cases. Higher white blood cell count and complications like ARDS and encephalopathy were linked to mortality.

Conclusions:

  • AKI resulting from multiple Hymenoptera stings represents a severe clinical condition with a substantial mortality rate.
  • Acute tubular necrosis (ATN) and acute interstitial nephritis (AIN) are the predominant histopathological findings on renal biopsy in these patients.
Keywords:
Hymenoptera stingsacute interstitial nephritisacute kidney injuryacute tubular necrosisenvenomation

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