Abstract
Snakebite is sometimes a cause of acute renal failure (ARF), especially from Viper species. The incidence of Viper bite is the lowest among the six poisoned snakes in Taiwan. Furthermore, there is a high incidence of oliguric ARF after a viper bite in Taiwan. We would like to report a 62 year-old male presented with oliguric ARF following Daboia russelli formosensis (Viper russelli formosensis) bite. Investigation at the time of the patient's arrival revealed hematuria, proteinuria, and prolonged coagulation parameters. Abnormal creatinin level was noted and rapidly increased to 2.5 mg/dL in 4 hours after admission. The patient got improved after antivenom infusion and th e oliguric ARF was corrected after hemodialysis and other supportive treatment. However, the cause of oliguric ARF after Daboia russelli formosensis bite could be a direct nephrotoxicity of systemic envenomation without DIC. Direct venom nephrotoxicity caused by venom of D. r. formosensis corresponds to the specific pathophysiological features of PLA2, which was different in degree and distinguished from those of other Asian countries. Suggestion has been made to pay more care to those snakebite victims when confirmed or even suspected from Viper species. Serum creatinin level is sufficient to detect ARF within one day in our case and related review in Taiwan.
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