Loganathan Muthusamy, Rajkumar Viswanathan, Balamurugan Subbiah
BACKGROUND A study of correlation between incidences of Acute Kidney Injury in patients admitted with snake bite with signs of localized envenomation- Cellulitis. The study also determines if there is any age or sex predilection for the severity of envenomation. MATERIALS AND METHODS 100 cases admitted at Government Mohan Kumaramangalam Medical College Hospital, Salem, during the period April 2015 to March 2016, with clinical evidence of snake bite envenomation were included in the study after taking into account the inclusion and exclusion criteria. Out of the 100 cases 56 were males and 44 were females. All the 100 cases were treated for snake envenomation and their laboratory work up and follow up data were collected and studied. RESULTS 44% of Snake bite victims have developed Acute Kidney Injury. Delay in admission was strongly correlated with development of Severe AKI (P<0.0005). Victims with co-morbidities are more prone to develop AKI and Complications. Most of the patients with AKI (93%) had Cellulitis and Lymphadenopathy (P<0.05). AKI is uncommon in Patients without coagulopathy. 80% of patients required conservative management only. 90% of AKI Patients recovered completely (P<0.0005). Only 6 patients of Stage 3 AKIN (24%) became dialysis dependent. 4 patients in AKIN3 group (16%) died due to complications of AKI (P<0.0005). People who were initiated on prompt medical therapy earlier and follow up showed signs of early recovery and favourable prognosis. This was also corroborated with the laboratory work up results of these patients. CONCLUSION Most of the patients with AKI (93%) had Cellulitis and Lymphadenopathy. AKI is uncommon in Patients without coagulopathy. 80% of patients were required conservative management only. The morbidity and mortality is high if severe cellulitis is associated with prolonged coagulopathy.
