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Incidence & prognosis of acute kidney injury in individuals of snakebite in a tertiary care hospital in India

BACKGROUND & OBJECTIVES: The snakebites are considered to be an occupational hazard in agriculture workers and the snake handlers, resulting in a considerable morbidity, mortality and economical implications. This study was conducted to determine the incidence, clinical presentation, renal injur...

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Autores principales: Pulimaddi, Ramulu, Parveda, Amruth Rao, Brahmanpally, Balkishan, Kalakanda, Paul Marx, Ramakrishna, K., Devi Chinnapaka, Venkata Ramana
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5926347/
https://www.ncbi.nlm.nih.gov/pubmed/29664034
http://dx.doi.org/10.4103/ijmr.IJMR_1581_16
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author Pulimaddi, Ramulu
Parveda, Amruth Rao
Brahmanpally, Balkishan
Kalakanda, Paul Marx
Ramakrishna, K.
Devi Chinnapaka, Venkata Ramana
author_facet Pulimaddi, Ramulu
Parveda, Amruth Rao
Brahmanpally, Balkishan
Kalakanda, Paul Marx
Ramakrishna, K.
Devi Chinnapaka, Venkata Ramana
author_sort Pulimaddi, Ramulu
collection PubMed
description BACKGROUND & OBJECTIVES: The snakebites are considered to be an occupational hazard in agriculture workers and the snake handlers, resulting in a considerable morbidity, mortality and economical implications. This study was conducted to determine the incidence, clinical presentation, renal injury and clinical outcome in snakebite victims who developed acute kidney injury (AKI). METHODS: This hospital-based prospective, observational study was done on 100 cases who were admitted for the management of snakebite and found to develop AKI in a tertiary care hospital at Hyderabad, India. Renal function tests, complete blood picture, urine routine examination, ultrasound examination of abdomen and coagulation profile were done and the prognosis was assessed by noting recovery, mortality, morbidity and/or progress to chronic stage. RESULTS: A total of 100 patients with a mean age of 43.80±12.63 yr (range 18-70); 62 males and 38 females were studied. All had bites on lower limbs. A total of 86 patients arrived in the hospital within 24 h, and 14 arrived after 24 h. Oliguria was found in 60, bleeding tendencies in 64, haemodynamic instability noted - tachycardia in 86. Systolic blood pressure (BP) was <120 mm Hg in 68 and BP was not recordable in four patients. Twelve patients were in stage III kidney disease and needed haemodialysis. Of the 100 cases of snakebite-induced acute kidney failure, 86 recovered and six died. On follow up, after six months eight patients developed chronic kidney failure. INTERPRETATION & CONCLUSIONS: A cascade of events tends to occur in severe haemotoxic envenomation such as bleeding disorders, hypotension/circulatory shock, intravascular haemolysis, disseminated intravascular coagulation and acute respiratory disease syndrome (ARDS). The findings of this study showed that early hospitalization, quick antisnake venom administration and adequate supporting care provided promising results.
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spelling pubmed-59263472018-05-08 Incidence & prognosis of acute kidney injury in individuals of snakebite in a tertiary care hospital in India Pulimaddi, Ramulu Parveda, Amruth Rao Brahmanpally, Balkishan Kalakanda, Paul Marx Ramakrishna, K. Devi Chinnapaka, Venkata Ramana Indian J Med Res Original Article BACKGROUND & OBJECTIVES: The snakebites are considered to be an occupational hazard in agriculture workers and the snake handlers, resulting in a considerable morbidity, mortality and economical implications. This study was conducted to determine the incidence, clinical presentation, renal injury and clinical outcome in snakebite victims who developed acute kidney injury (AKI). METHODS: This hospital-based prospective, observational study was done on 100 cases who were admitted for the management of snakebite and found to develop AKI in a tertiary care hospital at Hyderabad, India. Renal function tests, complete blood picture, urine routine examination, ultrasound examination of abdomen and coagulation profile were done and the prognosis was assessed by noting recovery, mortality, morbidity and/or progress to chronic stage. RESULTS: A total of 100 patients with a mean age of 43.80±12.63 yr (range 18-70); 62 males and 38 females were studied. All had bites on lower limbs. A total of 86 patients arrived in the hospital within 24 h, and 14 arrived after 24 h. Oliguria was found in 60, bleeding tendencies in 64, haemodynamic instability noted - tachycardia in 86. Systolic blood pressure (BP) was <120 mm Hg in 68 and BP was not recordable in four patients. Twelve patients were in stage III kidney disease and needed haemodialysis. Of the 100 cases of snakebite-induced acute kidney failure, 86 recovered and six died. On follow up, after six months eight patients developed chronic kidney failure. INTERPRETATION & CONCLUSIONS: A cascade of events tends to occur in severe haemotoxic envenomation such as bleeding disorders, hypotension/circulatory shock, intravascular haemolysis, disseminated intravascular coagulation and acute respiratory disease syndrome (ARDS). The findings of this study showed that early hospitalization, quick antisnake venom administration and adequate supporting care provided promising results. Medknow Publications & Media Pvt Ltd 2017-12 /pmc/articles/PMC5926347/ /pubmed/29664034 http://dx.doi.org/10.4103/ijmr.IJMR_1581_16 Text en Copyright: © 2017 Indian Journal of Medical Research http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Pulimaddi, Ramulu
Parveda, Amruth Rao
Brahmanpally, Balkishan
Kalakanda, Paul Marx
Ramakrishna, K.
Devi Chinnapaka, Venkata Ramana
Incidence & prognosis of acute kidney injury in individuals of snakebite in a tertiary care hospital in India
title Incidence & prognosis of acute kidney injury in individuals of snakebite in a tertiary care hospital in India
title_full Incidence & prognosis of acute kidney injury in individuals of snakebite in a tertiary care hospital in India
title_fullStr Incidence & prognosis of acute kidney injury in individuals of snakebite in a tertiary care hospital in India
title_full_unstemmed Incidence & prognosis of acute kidney injury in individuals of snakebite in a tertiary care hospital in India
title_short Incidence & prognosis of acute kidney injury in individuals of snakebite in a tertiary care hospital in India
title_sort incidence & prognosis of acute kidney injury in individuals of snakebite in a tertiary care hospital in india
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5926347/
https://www.ncbi.nlm.nih.gov/pubmed/29664034
http://dx.doi.org/10.4103/ijmr.IJMR_1581_16
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