EPIDEMIOLOGY AND CLINICAL FEATURES OF SNAKE BITE INDUCED ACUTE KIDNEY INJURY PATIENTS IN LAST DECADE AND ITS LONGTERM OUTCOME – A SINGLE CENTER EXPERIENCE.

Abstract

Snake envenomation and related clinical complication are of great relevance in tropical countries. The present study focuses on the epidemiological and clinicopathological prole of snake bite victims admitted or referred over the last decade to Nil Ratan Sircar Medical College and Hospital, a tertiary health care center located in eastern India. Acute kidney injury staging was done according to AKIN criteria. Snakebite patients were classied into acute kidney injury and non acute kidney injury group. Asubset of these patients admitted during the last year of the study were included in a prospective longitudinal follow up for the evaluation of long term renal consequences after snakebite induced acute kidney injury. Oliguria, hematuria, cellulitis, inammation were common in snake bite patient. All the plasma and urinary markers were signicantly altered after renal injury (p<0.05). Inammation and stress level were remain elevated over the 2 follow up time period. In the follow up of 42 patients, 14 patients showed <90 ml/min/1.73m estimated glomerular ltration rate, 18 patients showed higher urinary microprotein (>50mg/L), 14 patients showed elevated plasma creatinine (>1.2 mg/dl) and 16 patients showed hematuria at different follow up time periods up to 6 months. At the end of follow up, 15 patients (35.71%) showed signs of persistent renal insufciency indicating long term renal impairments