A Study of Acute Kidney Injury in Patients with Snakebite Envenomation
Journal Title: Journal of Medical Science And clinical Research - Year 2017, Vol 5, Issue 4
Abstract
Background and Objectives: Since long Snakebite-related acute kidney injury (AKI) is a common community-acquired AKI in tropical countries leading to death and disability. The aims of this study were to (1) determine the occurrence of snakebite-related AKI, (2) assess factors at presentation that are associated with snakebite-related AKI, and (3) determine the outcomes of patients with snakebiterelated AKI. Methods: We conducted a prospective observational study of patients with snake envenomation at our tertiary hospital during the calender year of 2016. Patient data including baseline characteristics, clinical and laboratory findings, hospital management, and outcomes were recorded in a case report form. A stepwise multivariate logistic regression analysis using a backward selection method determined independent factors significantly associated with AKI. Results: AKI was observed in 140 patients (54.3%), the majority of whom were AKI stage III (110 patients, 78.6%). AKI occurred at presentation and developed during hospitalization in 88 (62.9%) and 52 patients (37.1%), respectively. Twenty-seven patients died (19.3%), and 69 patients (49.3%) required dialysis. On multivariate logistic regression analysis, (1) snakebites from the Viperidae family (odds ratio [OR]: 9.65, 95% confidence interval [CI]: 2.42–38.44; p = 0.001), (2) WBC >10 × 103 cells/μL (OR: 3.55, 95% CI: 1.35–9.34; p = 0.010), (3) overt disseminated intravascular coagulation (OR: 2.23, 95% CI: 1.02–4.89; p = 0.045), (4) serum creatine kinase >500 IU/L (OR: 4.06, 95% CI: 1.71–9.63; p = 0.001), (5) serum sodium <135 mmol/L (OR: 4.37, 95% CI: 2.04– 9.38; p < 0.001), (6) presence of microscopic hematuria (OR: 3.60, 95% CI: 1.45–8.91; p = 0.006) Conclusions: If we dentify factors associated with snakebite-related AKI might help clinicians to be aware of snakebite patients who are at risk of AKI, particularly patients who demonstrate renal tubular dysfunction after Viperidae bites.
Authors and Affiliations
Pranay Gandhi
Keywords
Related Articles
- EP ID EP281404
- DOI -
- Views 94
- Downloads 0
Efficacy of Pharmacotherapy versus Combined Therapy in Tobacco Cessation: A Prospective Comparative Study
Background: In view of skyrocketing number of cases leading to increased prevalence of tobacco use, especially in developing countries the interventions for smoking cessation have become an urgent need of the hour. The a...
An Evaluation of the Metabolic Parameters in Women with Gestational Diabetes Mellitus after Delivery
Objective: To evaluate the metabolic parameters in women with gestational diabetes mellitus after delivery in north Indian women. Methods: This was a comparative study. A total of 50 patients were included in the study....
Candida rugosa Candidaemia in a Critically Ill Trauma Patient Successfully Treated with Amphotericin B
Candidemia is a common life threatening condition occurring in the hospitalized patients specially those admitted to the intensive care units. Candida rugosa is an uncommon species and a significant cause of candidemia a...
A Cross Sectional Study amongst Paramedical and Nursing Students Regarding Cancer Awareness at a Tertiary Healthcare Institute in Northern India
The rising cancer incidence makes cancer prevention, early diagnosis and treatment a priority. Paramedical workers and Nurses in India are the most important and the largest section of the paramedical workforce. Awarenes...
Effect of Pre Evacuation Serum Β hCG Levels on Post Evacuation Β hCG Regression in Molar Pregnancy
Background: Gestational trophoblastic disease encompasses several disease processes that originate in the placenta. Before 1969, metastatic choriocarcinoma was almost invariably fatal, whereas most patients are now cured...