Introduction:
Snakebite is a public health problem leading to 58,000 deaths every year in India. Acute Kidney injury subsequent to snakebite envenomation is common with a reported prevalence of up to 32% in India.
Methods:
Objectives: To study histopathological characteristics of patients who develop acute kidney injury following snake bite envenomation.
Methods:This study was a prospective study conducted at our tertiary care hospital, Kurnool Medical College over a period of 1 year (June 2023 to May 2024). During the 1 year period, 112 cases of snake bite envenomation were reported in the institute. Patients with history of snake bite, with clinical picture consistent with snake bite, as presence of fang marks or local cellulitis or coagulopathy with renal involvement were enrolled. Severe Acute Kidney injury following snake envenomation was seen in 23.7% (28 patients) underwent renal biopsy.
Results:
Results: 28 patients developed severe acute kidney injury (AKI) following snake bite envenomation. Renal biopsies were performed in all the patients. Median age was 45 years with predominantly males (57 %). Time duration from snake bite to renal biopsy ranges from 8 to 24 days. The predominant lesion on kidney biopsy was acute tubular necrosis (ATN) in 20 patients, 5 patients with acute interstitial nephritis (AIN) and 3 patients with thrombotic microangiopathy (TMA) with patchy cortical necrosis. All patients received standard treatment including polyvalent Antisnake venom and hemodialysis support. All patients with AIN received oral steroid (1mg/kg) which was gradually tapered over a period of 4 weeks. All the patients had renal recovery on follow up at 8 weeks except 1 patient with TMA had partial recovery at 12 weeks and out of hemodialysis.
Conclusions:
Conclusions: In conclusion, renal histopathological findings in snakebite envenomation-induced kidney injury, acute tubular necrosis was predominant histopathological lesions followed by acute interstitial nephritis, acute cortical necrosis due to thrombotic microangiopathy. Kidney biopsy is important and has a diagnostic and therapeutic and prognostic value for patients with snakebite envenomonation induced severe renal failure.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.