MO400HISTOPATHOLOGICAL SPECTRUM OF SNAKE- BITE INDUCED KIDNEY INJURY IN INDIA: A SYSTEMATIC REVIEW

Abstract

Abstract Background and Aims Snakebite is a public health problem leading to about 55,000 deaths every year in India.  Kidney injury subsequent to snakebite envenomation is common ( reported prevalence up to 32%). It is estimated that 3% of total acute kidney injury (AKI) is attributable to snakebites.  The current study aims to elucidate the spectrum of renal histopathology in AKI cases followed by snake bite. Method We searched seven electronic database studies to identify studies describing the histopathological findings in the kidney associated with snakebite envenomation from India. Two reviewers independently conducted titles and abstract screening as well as full-text evaluation for final inclusion decision. Data were extracted as per a standardized form and conducted narrative synthesis. Results We retrieved 1364 studies and finally included 21 studies involving 961 patients who met the eligibility criteria. Provisional results are presented. Patient ages ranged from 2.5 years to 80 years. Viper bite was the commonest cause related to AKI. 92 % of the  AKI  were oliguric and required dialysis. kidney biopsy was usually done after 3 weeks of AKI onset. Acute tubular necrosis (ATN) was the most common finding followed by acute interstitial nephritis, acute cortical necrosis, and thrombotic microangiopathy (TMA).Vasculitic changes in vessels were rarely reported. Conclusion Oligo-anuric presentation and prolonged kidney dysfunction were frequent in post snake bite AKI. ATN was the common histological finding