Online ISSN: 2515-8260

Keywords : Envenomation

A Hospital Based Prospective Study to Assess the Outcome of Acute Kidney Injury (AKI) in Snake Bite Patients at Newly Established Medical College

Dr.Hanuman Ram Choudhary, Dr.Anil Kumar Sethiya, Dr.Motilal Godara

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 2673-2678

Background: Snake envenomation is a serious medical crisis, wherein the spectrum of
injury can vary from local tissue damage to involvement of almost all vital organs of the
body. Hence, the need to recommend the most effective first aid to the victims bitten by
snakes and to recommend effective steps in the management of this problem. The aim of
this study to find out the incidence of acute kidney injury in snakebite patients.
Materials and Methods: This is a hospital-based prospective observational study in 50
consecutive patients, with history of poisonous snakebite, admitted to Government
Medical College & Hospital, Barmer, newly established tertiary referral centre in
western Rajasthan, India during one-year period. Snakebite and species identification
was confirmed by a reliable history from patients, patient's relatives, specimen brought
and presence of fang marks and signs of local and systemic envenomation. All patients
were interviewed using a standardized questionnaire to maintain a record of patient's
history relevant to snakebite envenomation. All these analyses were performed using a
commercially available software Statistical Package for the Social Sciences (SPSS) 21
version on personal computer.
Results: In our study, mean age group of AKI was 40.7 ± 13.21 years, incidence of AKI
was 60% in male and 40% in female and it was found to be 94% in rural population
and 6% in urban population. Only in 4% of cases, snakes were identified. Incidence of
AKI was found to be 30%.33.33% (N=1/3) of the patients with AKI had neurotoxicity
(p>0.05). Thus, not significant. None of the patients with AKI had brown or black
coloured urine. 75 % of patients with AKI had whole blood clotting time more than
20min (p-0.000), thus highly significant. AKI developed in 62.5% patients with bite to
ASV interval <= 2hours and 37.5% with interval >2 hours (p>0.05), thus not significant.
Conclusion: Snakebites are still a common medical emergency encountered, especially
in rural areas. Timely treatment is the mainstay for reduction of morbidity and
mortality. Recognition of predictor signs is essential for clinical management and early
referral which could lead to a significant decrease in morbidity and mortality. Further
long-term studies might help to assess predictors of renal failure in snake bite