Renal Involvement following Snake Bite Envenomation

Abstract

Aim: This study aimed to determine the frequency of renal involvement following snake envenomation and the risk factors that contribute to the development of such complications. Methods: This retrospective study was carried out at Asir Central Hospital, a tertiary and referral hospital located in the southern part of Saudi Arabia. Results: Overall, 134 cases of snakebite were identified during the 5-year period of 2015–2019. These included 100 male and 34 female patients, with a mean age of 30 ± 19 y. Hematuria and mild proteinuria were observed in 19.7% and 39.4% cases, respectively. Acute kidney injury (AKI) occurred in 17 cases (12.7%) and supportive renal replacement therapy was required in 4 cases. The cause of renal failure was based mainly on clinical ground with 6 cases due to pre-renal (volume loss due to bleeding) and 10 due to tubulo-interstitial lesions; one case presented with heavy proteinuria and hematuria, and glomerulonephritis was suspected. Full recovery occurred in 15 cases (88.2%), while a partial recovery with permanent damage was observed in 2 cases (11.8%) after follow-up for 24 months. Older age, duration of symptoms before treatment initiated (for instance, late presentation to the hospital), and abnormal coagulation in the form of disseminated intravascular coagulation (DIC) carry higher risk factors for the development of acute kidney injures (AKI ). Conclusions: In this study, AKI occurred in 12.7% victims of snakebite. Hemodialysis and supportive treatment appear to be the mainstay of the therapy in cases complicated with renal failure.