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Snake bite associated with acute kidney injury.

Subhankar Sarkar1, Rajiv Sinha2,3, Arpita Ray Chaudhury4

  • 1Division of Pediatric Nephrology, Institute of Child Health, Kolkata, 11, Dr Biresh Guha Street, Kolkata, West Bengal, 700017, India.

Pediatric Nephrology (Berlin, Germany)
|February 9, 2021
PubMed
Summary

Snake envenomation causes acute kidney injury (AKI) through venom toxins damaging kidney cells. Early diagnosis and treatment, including anti-snake venom and kidney support, are crucial for managing this life-threatening condition.

Keywords:
Acute kidney injuryAcute renal failurePoisoningSnake envenomationToxicologyTropical

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Area of Science:

  • Nephrology
  • Toxicology
  • Herpetology

Background:

  • Acute kidney injury (AKI) is a severe systemic complication of snake envenomation, particularly from Viperidae and Elapidae families.
  • Snake venom contains enzymatic toxins that inflict damage across all kidney compartments: glomerular, tubulo-interstitial, and vascular.
  • The pathogenesis is multifactorial, involving ischemia, glomerular basement membrane degradation, thrombotic microangiopathy, direct cytotoxicity, and rhabdomyolysis-induced myoglobinuria.

Purpose of the Study:

  • To elucidate the mechanisms and clinical features of AKI induced by snake envenomation.
  • To highlight the importance of early diagnosis and management strategies for snake bite-associated AKI.
  • To discuss the role of emerging biomarkers and supportive care in managing AKI.

Main Methods:

  • Review of existing literature on snake envenomation and its renal effects.
  • Analysis of the pathophysiological pathways leading to kidney damage.
  • Discussion of clinical manifestations and current management protocols.

Main Results:

  • Snake venom injures kidney cells via direct toxicity, ischemia, and microvascular damage.
  • Clinical signs of AKI include fatigue, nausea, vomiting, and reduced urine output (oliguria/anuria).
  • Effective management involves prompt anti-snake venom therapy, supportive care, and kidney replacement therapy when necessary.

Conclusions:

  • AKI is a critical, life-threatening consequence of snake envenomation requiring urgent medical attention.
  • Early detection and intervention, alongside comprehensive kidney support, are vital for improving patient outcomes.
  • Long-term monitoring is essential to prevent progression to chronic kidney disease (CKD).