Title: Early Prediction of Acute Kidney Injury by Clinical and Biochemical Parameters in Snakebite Patients
Authors: Dr Vinay S. Panchalwar, Dr Chandrashekhar M. Atkar, Dr Manu Vincent
DOI: https://dx.doi.org/10.18535/jmscr/v5i3.129
Abstract
Aims and Objectives: The present study was undertaken to determine early clinical and biochemical predictors for Acute Kidney Injury (AKI) among snake bite patients at the time of hospital admission and to determine incidence of AKI in snake bite patients.
Methods: We analyzed 200 cases with a poisonous snake bite. Patients were classified into two groups according to the presence and absence of AKI (AKI and No-AKI). History, findings of clinical examination and investigations of all patients were recorded and results were statistically compared.
Results: Out of 200 patients of snake bite, 63 developed AKI (31.5%). Among the clinical features, there was an independent positive association of AKI with bleeding tendencies, hypotension, wound complications and prolonged bite-to-initial Anti-Snake Venom (ASV) administration time. Similarly, among biochemical parameters, strong association of AKI was observed with hemoglobinuria, albuminuria, Red Blood Cells (RBC) in urine, elevated International Normalized Ratio (INR), elevated indirect bilirubin, decreased platelets and prolonged 20 min Whole Blood Clotting Time (WBCT) test.
Conclusions: Clinical manifestations (bleeding manifestations, hypotension, tenderness, progressive swelling and wound complications) and biochemical parameters (hemoglobinuria, albuminuria, RBC in urine, elevated INR, elevated indirect bilirubin, decreased platelets and prolonged 20min WBCT test) can be considered as early predictors of AKI among snake bite patients including delayed presentation to hospital resulting in prolonged bite-to-initial ASV administration time.
Keywords: Acute Kidney Injury (AKI), Clinical and biochemical predictors, Snake bite, Anti-Snake venom (ASV).
Dr Vinay S. Panchalwar
Associate Professor, Department of General Medicine, Government Medical College,
Nagpur, Maharashtra, India-440001
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.
