Early Prediction of Acute Kidney Injury by Clinical and Biochemical Parameters in Snakebite Patients
Journal Title: Journal of Medical Science And clinical Research - Year 2017, Vol 5, Issue 3
Abstract
Aims and Objectives: The present study was undertaken to determine early clinical and biochemical predictors for Acute Kidney Injury (AKI) among snake bite patients at the time of hospital admission and to determine incidence of AKI in snake bite patients. Methods: We analyzed 200 cases with a poisonous snake bite. Patients were classified into two groups according to the presence and absence of AKI (AKI and No-AKI). History, findings of clinical examination and investigations of all patients were recorded and results were statistically compared. Results: Out of 200 patients of snake bite, 63 developed AKI (31.5%). Among the clinical features, there was an independent positive association of AKI with bleeding tendencies, hypotension, wound complications and prolonged bite-to-initial Anti-Snake Venom (ASV) administration time. Similarly, among biochemical parameters, strong association of AKI was observed with hemoglobinuria, albuminuria, Red Blood Cells (RBC) in urine, elevated International Normalized Ratio (INR), elevated indirect bilirubin, decreased platelets and prolonged 20 min Whole Blood Clotting Time (WBCT) test. Conclusions: Clinical manifestations (bleeding manifestations, hypotension, tenderness, progressive swelling and wound complications) and biochemical parameters (hemoglobinuria, albuminuria, RBC in urine, elevated INR, elevated indirect bilirubin, decreased platelets and prolonged 20min WBCT test) can be considered as early predictors of AKI among snake bite patients including delayed presentation to hospital resulting in prolonged bite-to-initial ASV administration time
Authors and Affiliations
Dr Vinay S. Panchalwar
Keywords
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