A Study of Clinical Profile and Outcome of Patients with Snake Bite induced Acute Renal failure at RIMS, Ranchi, Jharkhand

Dr. Ram Sewak Sahu; Dr. Priyanka Sahu; Dr. Debarshi Jana

Volume : IX, Issue : VI, June - 2020

A Study of Clinical Profile and Outcome of Patients with Snake Bite induced Acute Renal failure at RIMS, Ranchi, Jharkhand

Dr. Ram Sewak Sahu, Dr. Priyanka Sahu, Dr. Debarshi Jana

Abstract :

BACKGROUND: Snake bite poisoning is known to man since antiquity. It is a well–known occupational hazard amongst farmers, plantation workers, and other outdoor workers and results in much morbidity and mortality throughout the world. The acute renal failure in snake bite patients largely a preventable complication. So the patients with snake bite should be hospitalized and monitored for early detection of renal complications. This study is an attempt to analyze the clinical profile of snake bite patients and evaluation of acute renal failure in them. OBJECTIVES: To study the renal involvement in patients with snake bite with reference to clinical features and the time of onset of acute renal failure. To study the course, need for renal replacement therapy including dialysis and outcome. METHODS: A prospective clinical study of 100 patients of snake bite was done to know the clinical profile and outcome in Rajendra Institute of Medical Sciences (RIMS), Ranchi, Jharkhand, and particularly looked for development of acute renal failure. Later each case is studied and investigated with respect to clinical features, course in the hospital, onset of ARF, need for renal replacement therapy including dialysis and mortality due to ARF. Patients were followed till discharge or death. They were treated as per protocol. Clinical data was tabulated. Statistical analysis (SPSS) was done. RESULTS: The incidence of ARF was (20%), majority of patients were between 31 to 50 years of age. Male patients were predominant with (68%) and (32%) were female. Most of the patients reported within 4 hours of bite. Common signs and symptoms were pain (99%), swelling (81%), cellulitis (26%), hematuria (26%) and oliguria (20%). Hypotension was present in (15%) of cases which is an important cause of ARF. All the ARF patients showed coagulation abnormalities (WBCT >20 minutes). Hemodialysis was done in 5 patients. Among 100 patients mortality was (2%) and the remaining (98%) recovered completely. CONCLUSION: Causes of ARF in snakebite was multifactorial in origin. Bleeding and hypotension are among the important causes of ARF. Type of snakebite is another important factor in the development of ARF and Russell�s viper bite is more commonly associated with ARF. Lapse of time in presenting to the hospital and abnormal coagulation profile are the predictors of poor outcome. ARF is usually associated with oliguria and generally occurs within 24 hours. Most of the ARF patients had recovered completely with effective management.