Acute renal failure following snakebite.
Eight patients with acute renal failure following snakebite were studied. Intravascular hemolysis and disseminated intravascular coagulation contributed to the development of acute renal failure in 6 patients. Direct nephrotoxicity causing acute renal failure is postulated in 2 patients, 1 of whom also revealed evidence of mild, disseminated intravascular coagulation. Three patients had histopathological lesions of acute symmetrical cortical necrosis and 3 had acute tubular necrosis. In 1 patient with acute tubular necrosis, in whom direct nephrotoxicity seemed to be responsible for renal failure, the striking histological feature was a uniform debasement and disappearance of tubular epithelium. In 2 patients with a clinical course of acute tubular necrosis, histological lesions could not be documented. All the 5 patients with acute tubular necrosis regained full recovery of renal function, 3 of them with the help of dialysis and 2 with conservative management. None of the 3 patients with acute cortical necrosis survived in spite of intermittent dialysis therapy.
D058186:Acute Kidney Injury / Q000097:blood / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D000293:Adolescent; D000328:Adult; D001706:Biopsy; D001780:Blood Coagulation Tests; D002648:Child; D004211:Disseminated Intravascular Coagulation / Q000209:etiology; D004844:Epistaxis / Q000209:etiology; D005260:Female; D005342:Fibrinolysis; D006417:Hematuria / Q000209:etiology; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D007565:Jaundice / Q000209:etiology; D007668:Kidney / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009846:Oliguria / Q000209:etiology; D006435:Renal Dialysis; D012909:Snake Bites / Q000097:blood / Q000150:complications* / Q000473:pathology / Q000628:therapy