title: Clinical predictors of acute kidney injury following snake bite envenomation.
abstract: BACKGROUND
  Snake bite envenomation is a major public health concern in developing countries. Acute kidney injury (AKI) is as important cause of mortality in patients with vasculotoxic snake bite.
  
  
  OBJECTIVE
  This study was to evaluate the clinical profile of snake bite patients and to determine the predictors of developing AKI following snake bite.
  
  
  METHODS
  Two hundred and eighty-one patients with snake envenomation were included. Eighty-seven patients developed AKI (Group A) and 194 (Group B) did not. History, examination findings and investigations results were recorded and compared between the two groups.
  
  
  RESULTS
  In group A, 61 (70.11%) patients were male and in group B, 117 (60.30%) patients were male. Out of 281 patients, 232 had cellulitis, 113 had bleeding tendencies, 87 had oliguria, 76 had neuroparalysis, and 23 had hypotension at presentation. After multivariate analysis, bite to hospital time (P = 0.016), hypotension (P = 0.000), albuminuria (P = 0.000), bleeding time (P = 0.000), prothrombin time (P = 0.000), hemoglobin (P = 0.000) and total bilirubin (P = 0.010) were significant independent predictors of AKI.
  
  
  CONCLUSIONS
  AKI developed in 30.96% of patients with snake bite, leading to mortality in 39.08% patients. Factors associated with AKI are bite to hospital time, hypotension, albuminuria, prolonged bleeding time, prolonged prothrombin time, low hemoglobin and a high total bilirubin.
authors.affiliation: Department of Medicine, Government Medical College, Nagpur, Maharashtra, India.
authors.forename: Mrudul V
authors.initials: MV
authors.lastname: Dharod
authors.affiliation: Department of Medicine, Government Medical College, Nagpur, Maharashtra, India.
authors.forename: Tushar B
authors.initials: TB
authors.lastname: Patil
authors.affiliation: Department of Medicine, Government Medical College, Nagpur, Maharashtra, India.
authors.forename: Archana S
authors.initials: AS
authors.lastname: Deshpande
authors.affiliation: Department of Medicine, Government Medical College, Nagpur, Maharashtra, India.
authors.forename: Ragini V
authors.initials: RV
authors.lastname: Gulhane
authors.affiliation: Department of Medicine, Government Medical College, Nagpur, Maharashtra, India.
authors.forename: Mangesh B
authors.initials: MB
authors.lastname: Patil
authors.affiliation: Department of Medicine, Government Medical College, Nagpur, Maharashtra, India.
authors.forename: Yogendra V
authors.initials: YV
authors.lastname: Bansod
keywords: Acute kidney injury; Bite to hospital time; Coagulopathy; Envenomation; Hemolysis; Snake bite