Journal of Integrative Nephrology and Andrology

ORIGINAL ARTICLE
Year
: 2018  |  Volume : 5  |  Issue : 1  |  Page : 14--17

Snake envenomation-induced acute interstitial nephritis


Thanigachalam Dineshkumar, Jeyachandran Dhanapriya, Subramaniam Murugananth, Dhanikachalam Surendar, Ramanathan Sakthirajan, Dhanasekaran Rajasekar, T Balasubramaniyan, Natarajan Gopalakrishnan 
 Department of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India

Correspondence Address:
Dr. Jeyachandran Dhanapriya
Department of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai - 600 003, Tamil Nadu
India

Background and Objectives: Acute kidney injury (AKI) is one of the major complications of snake envenomation, especially in the developing countries. The most common renal histology in snakebite-induced AKI is acute tubular injury (ATI), but acute interstitial nephritis (AIN) is rarely reported. Materials and Methods: We did a prospective observational study between January 2012 and May 2017 to analyze the demographic, clinical, and laboratory data, response to treatment, and outcome of patients with snakebite-induced AIN. Results: About twenty patients were included in the study with mean follow-up of 24 ± 6 months. Of them, 6 (30%) were males. Mean age was 50.9 ± 22.1 years. All the patients received anti-snake venom. AKI developed after a mean duration of 24.1 ± 11.2 h and 15 patients were oliguric. Cellulitis was seen in 65% of patients, anemia in 65%, leukocytosis and thrombocytopenia in 40%, and coagulopathy in 80%. Mean peak serum creatinine was 7.8 ± 3.2 mg/dL. Peripheral eosinophilia was seen in 7 (35%) patients. All the patients were managed with hemodialysis and all except one received oral steroids. Six patients (30%) progressed to chronic kidney disease (CKD) with mean follow-up creatinine of 1.49 ± 0.8 mg/dL. Conclusion: It is prudent to do renal biopsy in patients with snakebite-induced AKI when there is a suspicion of pathology other than ATI. Identification and treatment of AIN with steroid will avoid progression to CKD which has an impact on growing health burden in tropical countries.


How to cite this article:
Dineshkumar T, Dhanapriya J, Murugananth S, Surendar D, Sakthirajan R, Rajasekar D, Balasubramaniyan T, Gopalakrishnan N. Snake envenomation-induced acute interstitial nephritis.J Integr Nephrol Androl 2018;5:14-17


How to cite this URL:
Dineshkumar T, Dhanapriya J, Murugananth S, Surendar D, Sakthirajan R, Rajasekar D, Balasubramaniyan T, Gopalakrishnan N. Snake envenomation-induced acute interstitial nephritis. J Integr Nephrol Androl [serial online] 2018 [cited 2019 Aug 20 ];5:14-17
Available from: http://www.journal-ina.com/article.asp?issn=2394-2916;year=2018;volume=5;issue=1;spage=14;epage=17;aulast=Dineshkumar;type=0