Clinical profile and outcome of AKI in snake bite in a tertiary care hospital, India

Abstract

Introduction: Acute kidney injury (AKI) is one of the complications of envenomation that is frequently fatal. Aim: To evaluate the clinical profile and outcome of AKI in snake bite patients and to identify the predictors of mortality in these patients. Methods: All patients admitted with history of envenomation and AKI were included in the study. A detailed history was obtained from all the patients about the time of antisnake venom administration and time interval between the event and admission in hospital, and then hematological and biochemical investigations were performed. Results: A total of 202 patients were diagnosed with snake bite induced AKI, of which 8.6% had died. Majority of patients were males (82.7%). The dialysis requirement was significantly higher in patients who died as compared to those who survived (100% vs. 72.6%, p = 0.013). The disseminated intravascular coagulation was found to be higher in patients who died due to snake bite (p < 0.001). The median (range) length of hospitalization was shorter for the nonsurvivors than the survivors (3.0 [1.0–4.0] days vs. 8.0 [3.0–27.0] days; p < 0.001). Compared to patients who survived, the total leukocyte count and serum urea were significantly higher among patients who died due to snake bite induced AKI. Conclusion: The present study revealed that higher dialysis requirement, high complication rate, and lower duration of hospital stay were the risk factors associated with patients who died due to snake bite induced AKI.