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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 BMC+Nephrol
2017 ; 18
(1
): 92
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Clinical and laboratory parameters associated with acute kidney injury in
patients with snakebite envenomation: a prospective observational study from
Myanmar
#MMPMID28302077
Aye KP
; Thanachartwet V
; Soe C
; Desakorn V
; Thwin KT
; Chamnanchanunt S
; Sahassananda D
; Supaporn T
; Sitprija V
BMC Nephrol
2017[Mar]; 18
(1
): 92
PMID28302077
show ga
BACKGROUND: Snakebite-related acute kidney injury (AKI) is a common
community-acquired AKI in tropical countries leading to death and disability. The
aims of this study were to (1) determine the occurrence of snakebite-related AKI,
(2) assess factors at presentation that are associated with snakebite-related
AKI, and (3) determine the outcomes of patients with snakebite-related AKI.
METHODS: We conducted a prospective observational study of patients with snake
envenomation at the three academic tertiary care hospitals in Yangon, Myanmar
between March 2015 and June 2016. Patient data including baseline
characteristics, clinical and laboratory findings, hospital management, and
outcomes were recorded in a case report form. A stepwise multivariate logistic
regression analysis using a backward selection method determined independent
factors significantly associated with AKI. RESULTS: AKI was observed in 140
patients (54.3%), the majority of whom were AKI stage III (110 patients, 78.6%).
AKI occurred at presentation and developed during hospitalization in 88 (62.9%)
and 52 patients (37.1%), respectively. Twenty-seven patients died (19.3%), and 69
patients (49.3%) required dialysis. On multivariate logistic regression analysis,
(1) snakebites from the Viperidae family (odds ratio [OR]: 9.65, 95% confidence
interval [CI]: 2.42-38.44; p?=?0.001), (2) WBC >10?×?10(3) cells/?L (OR: 3.55,
95% CI: 1.35-9.34; p?=?0.010), (3) overt disseminated intravascular coagulation
(OR: 2.23, 95% CI: 1.02-4.89; p?=?0.045), (4) serum creatine kinase >500 IU/L
(OR: 4.06, 95% CI: 1.71-9.63; p?=?0.001), (5) serum sodium <135 mmol/L (OR: 4.37,
95% CI: 2.04-9.38; p?0.001), (6) presence of microscopic hematuria (OR: 3.60,
95% CI: 1.45-8.91; p?=?0.006), and (7) duration from snakebite to receiving
antivenom ?2 h (OR: 3.73, 95% CI: 1.48-9.37; p?=?0.005) were independently
associated with AKI. Patients bitten by Viperidae with normal renal function who
had serum sodium <135 mmol/L had a significantly higher urine
sodium-to-creatinine ratio than those with serum sodium ?135 mmol/L (p?0.001).
CONCLUSIONS: Identifying factors associated with snakebite-related AKI might help
clinicians to be aware of snakebite patients who are at risk of AKI, particularly
patients who demonstrate renal tubular dysfunction after Viperidae bites.
|Acute Kidney Injury/*diagnosis/*mortality
[MESH]
|Adult
[MESH]
|Causality
[MESH]
|Clinical Laboratory Techniques/*statistics & numerical data
[MESH]
|Comorbidity
[MESH]
|Diagnosis, Differential
[MESH]
|Female
[MESH]
|Hospital Mortality
[MESH]
|Humans
[MESH]
|Kidney Function Tests/*statistics & numerical data
[MESH]
|Male
[MESH]
|Myanmar
[MESH]
|Physical Examination/*statistics & numerical data
[MESH]