Snake envenomation-induced acute kidney injury: prognosis and long-term renal outcomes.


Journal

Postgraduate medical journal
ISSN: 1469-0756
Titre abrégé: Postgrad Med J
Pays: England
ID NLM: 0234135

Informations de publication

Date de publication:
Apr 2022
Historique:
received: 16 09 2020
revised: 04 12 2020
accepted: 07 12 2020
pubmed: 12 3 2021
medline: 25 3 2022
entrez: 11 3 2021
Statut: ppublish

Résumé

Snake bite continues to be a significant cause of acute kidney injury (AKI) in India. There is paucity of data regarding long-term outcomes of such patients. In this study, we aim to assess the prognosis and long-term renal outcomes of such patients. We analysed the hospital records of snake envenomation-induced AKI from January 2015 to December 2018. Predictors of in-hospital mortality were assessed. Survivors were advised to visit follow-up clinic to assess their kidney function. There were 769 patients with evidence of envenomation and of them, 159 (20.7%) had AKI. There were 112 (70.4%) males. Mortality occurred in 9.4% of patients. Logistic regression analysis identified shock (OR 51.949, 95% CI 4.297 to 628.072) and thrombocytopenia (OR 27.248, 95% CI 3.276 to 226.609) as predictors of mortality. Forty-three patients attended the follow-up. The mean follow-up duration was 30.4±15.23 months. Adverse renal outcomes (eGFR <60 mL/min/1.73 m The incidence of AKI in snake envenomation was 20.7%. The presence of shock and thrombocytopenia were associated with mortality. Adverse renal outcomes occurred in 48.8% of patients in the long term.

Sections du résumé

BACKGROUND BACKGROUND
Snake bite continues to be a significant cause of acute kidney injury (AKI) in India. There is paucity of data regarding long-term outcomes of such patients. In this study, we aim to assess the prognosis and long-term renal outcomes of such patients.
METHODS METHODS
We analysed the hospital records of snake envenomation-induced AKI from January 2015 to December 2018. Predictors of in-hospital mortality were assessed. Survivors were advised to visit follow-up clinic to assess their kidney function.
RESULTS RESULTS
There were 769 patients with evidence of envenomation and of them, 159 (20.7%) had AKI. There were 112 (70.4%) males. Mortality occurred in 9.4% of patients. Logistic regression analysis identified shock (OR 51.949, 95% CI 4.297 to 628.072) and thrombocytopenia (OR 27.248, 95% CI 3.276 to 226.609) as predictors of mortality. Forty-three patients attended the follow-up. The mean follow-up duration was 30.4±15.23 months. Adverse renal outcomes (eGFR <60 mL/min/1.73 m
CONCLUSIONS CONCLUSIONS
The incidence of AKI in snake envenomation was 20.7%. The presence of shock and thrombocytopenia were associated with mortality. Adverse renal outcomes occurred in 48.8% of patients in the long term.

Identifiants

pubmed: 33692155
pii: postgradmedj-2020-139021
doi: 10.1136/postgradmedj-2020-139021
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

264-268

Informations de copyright

© Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: None declared.

Auteurs

Manoj Kumar (M)

Institute of Nephrology, Madras Medical College, Chennai, Tamil Nadu, India manoj.k.king@gmail.com.

Maasila Arcot Thanjan (M)

Nephrology, Government Vellore Medical College and Hospital, Vellore, Tamil Nadu, India.

Natarajan Gopalakrishnan (N)

Institute of Nephrology, Madras Medical College, Chennai, Tamil Nadu, India.

Dhanapriya Jeyachandran (D)

Institute of Nephrology, Madras Medical College, Chennai, Tamil Nadu, India.

Dineshkumar Thanigachalam (D)

Institute of Nephrology, Madras Medical College, Chennai, Tamil Nadu, India.

Sakthirajan Ramanathan (S)

Institute of Nephrology, Madras Medical College, Chennai, Tamil Nadu, India.

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