title: Renal cortical necrosis following Bothrops jararaca and B. jararacussu snake bite.
abstract: Out of 22 patients admitted to the Intensive Care Unit of the Hospital das Clínicas, Federal University of Minas Gerais, with acute renal failure following Bothrops snake bite, 7 had renal cortical necrosis. This complication was suspected when the oligoanuric phase ranged from 21 to 28 days or when the patient, in spite of having a polyuric phase, maintained elevated blood levels of urea and creatinine after the interruption of the dialysis program, and was confirmed by a kidney biopsy. Three patients died and in two of them renal cortical necrosis was found at necropsy. Four patients were discharged from the hospital and follow-up was possible in two of them who showed recovery of renal function. Vasospasm, direct nephrotoxicity of Bothrops venom and/or disseminated intravascular coagulation leading to vascular occlusion and renal ischemia are the proposed pathogenetic mechanisms to explain renal cortical necrosis following Bothrops snake bite.
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology* / Q000628:therapy; D000293:Adolescent; D000328:Adult; D000368:Aged; D003435:Crotalid Venoms; D005260:Female; D006801:Humans; D007673:Kidney Cortex Necrosis / Q000209:etiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis; D012909:Snake Bites / Q000150:complications*
chemical_list: D003435:Crotalid Venoms