Snake bite-induced acute renal failure: A study of clinical profile and predictors of poor outcome

Abstract

Aims: Acute renal failure is an important cause of morbidity and mortality in snake bite patients, especially in tropical countries. This study was aimed to describe clinical profile and to identify predictors of poor outcome in snake bite-induced acute renal failure. Settings and Design: This was a retrospective observational study, conducted in a tertiary care hospital. Materials and Methods: 57 patients of snake bite-induced ARF, who required dialysis, were included. Clinical history taking, physical examination, and laboratory evaluation was done. All patients received standard treatment including anti-snake venom. Patients received peritoneal or hemodialysis depending on availability of resources. The Pearson Chi-Square test was used to analyze parametric variables. Results: Prevalence of ARF in snake bite was 20.48%. Common clinical manifestations were local cellulitis (100%), oliguria (84.2%), edema (33.3%), hematuria (29.8%), altered sensorium (26.3%), and bleeding manifestations (22.8%). Common laboratory findings were albuminuria (100%), anemia (54.3%); leucocytosis (61.4%); thrombocytopenia (42.1%); coagulopathy (36.8%); metabolic acidosis (31.5%). Conclusions: Snake bite-induced ARF has mortality of 15.5%. The factors associated with mortality were presence of coagulopathy and uremic encephalopathy. Though this study is not designed to compare hemodialysis and peritoneal dialysis, the better outcome in hemodialysis group suggests the need to compare the 2 modalities of renal replacement therapy in patients with snake bite-induced acute renal failure.