title: Acute Kidney Injury and Rhabdomyolysis After Protobothrops flavoviridis Bite: A Retrospective Survey of 86 Patients in a Tertiary Care Center.
abstract: Acute kidney injury (AKI) is the main cause of death for victims of hematoxic snakebites. A few studies have described improvement in AKI rates in snakebite cases, but the reasons for the improvement have not been investigated. Eighty-six patients with Protobothrops flavoviridis bites admitted to a single center from January 2003 through March 2014 were included in the study. Clinical variables, including age, sex, blood pressure (BP), and serum creatinine (S-Cre), on admission were compared between patients with and without AKI. One patient died of disseminated intravascular coagulation following AKI (mortality rate 1.1%). Six patients developed AKI with rhabdomyolysis. Systolic BP, S-Cre, serum creatine kinase, white blood cell count, and platelet count differed significantly between the AKI and non-AKI groups (P = 0.01). Three of the six patients were physically challenged to a degree that made it difficult for them to move or communicate, and these difficulties likely exacerbated the severity of snakebite complications. Our study demonstrated that the risk of snakebite-induced AKI for physically challenged patients was high. To further reduce mortality due to snakebite-induced AKI, we need to make it possible for physically challenged patients to receive first aid sooner.
authors.affiliation: Division of Blood Purification, Kagoshima Prefectural Ohshima Hospital, Kagoshima, Japan; Department of Urology, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan; Blood Purification Center, Kagoshima University Hospital, Kagoshima, Japan nishimura.hiroaki@gmail.com.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nishimura
authors.affiliation: Division of Blood Purification, Kagoshima Prefectural Ohshima Hospital, Kagoshima, Japan; Department of Urology, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan; Blood Purification Center, Kagoshima University Hospital, Kagoshima, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Enokida
authors.affiliation: Division of Blood Purification, Kagoshima Prefectural Ohshima Hospital, Kagoshima, Japan; Department of Urology, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan; Blood Purification Center, Kagoshima University Hospital, Kagoshima, Japan.
authors.forename: Shuichirou
authors.initials: S
authors.lastname: Kawahira
authors.affiliation: Division of Blood Purification, Kagoshima Prefectural Ohshima Hospital, Kagoshima, Japan; Department of Urology, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan; Blood Purification Center, Kagoshima University Hospital, Kagoshima, Japan.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Kagara
authors.affiliation: Division of Blood Purification, Kagoshima Prefectural Ohshima Hospital, Kagoshima, Japan; Department of Urology, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan; Blood Purification Center, Kagoshima University Hospital, Kagoshima, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Hayami
authors.affiliation: Division of Blood Purification, Kagoshima Prefectural Ohshima Hospital, Kagoshima, Japan; Department of Urology, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan; Blood Purification Center, Kagoshima University Hospital, Kagoshima, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Nakagawa
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology* / Q000473:pathology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D002648:Child; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012206:Rhabdomyolysis / Q000209:etiology* / Q000473:pathology*; D012909:Snake Bites / Q000453:epidemiology / Q000473:pathology*; D017819:Viperidae; D055815:Young Adult