Rubina Naqvi1. 1. Department of Nephrology, Sindh Institute of Urology and Transplantation (SIUT), Karachi.
Abstract
OBJECTIVE: To describe the clinical spectrum and outcome of patients presenting to a tertiary care kidney center, developing acute kidney injury (AKI) after snake-bite. STUDY DESIGN: An observational study. PLACE AND DURATION OF STUDY: Nephrology Department, Sindh Institute of Urology and Transplantation (SIUT), Karachi, from January 1990 to December 2014. METHODOLOGY: All patients coming to SIUTidentified as having AKI after snake-bite during the study period were included. AKI was defined according to RIFLE criteria with sudden rise in creatinine or decline in urine output or both. Demographics, clinical presentation, laboratory profile, and final outcome was noted. RESULTS: During the studied period, 115 cases of AKI, secondary to snake-bite, were registered at this institution. Median age of patients was 35.92 ±15.04 (range: 6 - 70) years and male to female ratio was 1.6:1. Time from bite and referral to this hospital ranged from 2 to 28 days (mean: 8.77 ±5.58 days). Oligo-anuria was the most common presentation, being found in 98 (93.90%) patients. Bleeding diathesis was reported in 75 (65.21%) patients on presentation. All patients had normal sized, non-obstructed kidneys on ultrasonography, with no previous comorbids. Renal replacement therapy (RRT) was required in 106 (92.17%) patients. Complete recovery was seen in 59 (51.30%), while 15 (13.04%) patients expired during acute phase of illness, 4 (3.47%) developed CKD, 11 (9.56%) required dialysis beyond 90 days, and 26 (22.60%) were lost to long-term follow-up. CONCLUSION: Snake-bite, leading to multiple complications including renal failure and death, is a major health issue in tropical countries. Late referral of these patients to specialized centres results in undesirable outcome.
OBJECTIVE: To describe the clinical spectrum and outcome of patients presenting to a tertiary care kidney center, developing acute kidney injury (AKI) after snake-bite. STUDY DESIGN: An observational study. PLACE AND DURATION OF STUDY: Nephrology Department, Sindh Institute of Urology and Transplantation (SIUT), Karachi, from January 1990 to December 2014. METHODOLOGY: All patients coming to SIUTidentified as having AKI after snake-bite during the study period were included. AKI was defined according to RIFLE criteria with sudden rise in creatinine or decline in urine output or both. Demographics, clinical presentation, laboratory profile, and final outcome was noted. RESULTS: During the studied period, 115 cases of AKI, secondary to snake-bite, were registered at this institution. Median age of patients was 35.92 ±15.04 (range: 6 - 70) years and male to female ratio was 1.6:1. Time from bite and referral to this hospital ranged from 2 to 28 days (mean: 8.77 ±5.58 days). Oligo-anuria was the most common presentation, being found in 98 (93.90%) patients. Bleeding diathesis was reported in 75 (65.21%) patients on presentation. All patients had normal sized, non-obstructed kidneys on ultrasonography, with no previous comorbids. Renal replacement therapy (RRT) was required in 106 (92.17%) patients. Complete recovery was seen in 59 (51.30%), while 15 (13.04%) patients expired during acute phase of illness, 4 (3.47%) developed CKD, 11 (9.56%) required dialysis beyond 90 days, and 26 (22.60%) were lost to long-term follow-up. CONCLUSION: Snake-bite, leading to multiple complications including renal failure and death, is a major health issue in tropical countries. Late referral of these patients to specialized centres results in undesirable outcome.
Authors: Eliane Campos Alves; Jacqueline de Almeida Gonçalves Sachett; Vanderson Souza Sampaio; José Diego de Brito Sousa; Sâmella Silva de Oliveira; Elizandra Freitas do Nascimento; Alessandra Dos Santos Santos; Iran Mendonça da Silva; Ana Maria Moura da Silva; Fan Hui Wen; Mônica Colombini; Marcus Vinicius Guimarães de Lacerda; Wuelton Marcelo Monteiro; Luiz Carlos de Lima Ferreira Journal: PLoS One Date: 2018-08-17 Impact factor: 3.240