Citation

Albuquerque PL, Silva Junior GB, Jacinto CN, Lima JB, Lima CB, Amaral YS, Veras MD, Mota RM, Daher EF. Nephrology 2014; 19(12): 764-770.

Affiliation

Toxicological Assistance Center, Instituto Dr. José Frota. Fortaleza, Ceará, Brazil; Post-Graduation Program in Medical Sciences, Department of Internal Medicine, School of Medicine, Federal University of Ceará. Fortaleza, Ceará, Brazil.

Copyright

(Copyright © 2014, John Wiley and Sons)

DOI

10.1111/nep.12327

PMID

25123203

Abstract

BACKGROUND: Acute kidney injury (AKI) is one of the main causes of morbidity and mortality in cases of envenomation by venomous snakes. The present study was carried out to investigate the clinical and laboratory manifestations in accidents with venomous snakes and the risk factors associated with AKI in these accidents.

METHODS: A retrospective study was carried out with patients victims of snakebite admitted to a reference center. AKI was defined according to the RIFLE and AKIN criteria.

RESULTS: A total of 276 patients were included, of which 230 (83.7%) were males. AKI was observed in 42 cases (15.2%). The mean genus involved in the accidents was Bothrops (82.2%). Mean age of patients with AKI was higher than in patients without AKI (43±20 vs. 34±21 years, p=0.015). The time elapsed between the accident and medical care was higher in the AKI group (25±28 vs. 14±16h, p=0.034), as well as the time elapsed between the accident and the administration of antivenom (30.7±27 vs. 15±16h, p=0.01). Hemodialysis was required in 30% of cases and complete renal function recovery was observed in 54.8% of cases at hospital discharge. There were 4 deaths, none of which had AKI. Factors associated with AKI were hemorrhagic abnormalities (p=0.036, OR=6.718, 95% CI: 1.067-25.661) and longer length of hospital stay (p=0.004, OR=1.69, 95% CI 1.165-2.088).

CONCLUSION: AKI is an important complication of snakebite accidents, showing low mortality, but high morbidity, which can lead to partial renal function recovery.

Language: en