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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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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Medknow Publications & Media Pvt Ltd
2017
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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. |
format | Online Article Text |
id | pubmed-5926347 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
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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