A study on clinico-epidemiological profile and determination of clinical predictors of acute kidney injury following snake bite envenomation in a tertiary care hospital in Eastern India.

Background: Snake bite is a major public health issue in India causing significant morbidity and mortality. But, due to lack of awareness and unscientific treatment practices there is under-reporting of cases. In this study we wanted to know about epidemiological profile of snake bite patients and to assess the risk factors of acute kidney injury following poisonous snake bite. Materials and methods: It was a prospective, observational, single institutional study among patients admitted with snake bite in general medicine ward of our institute between January 2020 to September 2021. After selection, proper history, detailed clinical examination and some laboratory examination like-Renal function test, coagulation profile was done. We assessed different clinical/laboratory parameters that were significantly associated with Acute kidney injury(AKI). Results: Among total 100 patients, 56% of patients developed AKI. There was significantly higher incidences of swelling (98% vs 65%, p-value-0.001), bleeding (62.5% vs 6.8%, p-value-0.002) and cellulitis (75% vs 9%, p-value-0.004) in patients with AKI than patients without AKI. Significantly deranged coagulation profile in terms of raised bleeding time of >10 minutes (67% vs 0%, p-value-0.003), abnormal Prothrombin Time (PT), Activated partial Thromboplastin Time (APTT), Whole blood clotting time (WBCT) of >20 minutes, deranged INR (International normalized Ratio) >1.5 (3% vs 0%, p-value-0.003) was seen in AKI patients. Conclusion: So, from our study multiple clinical parameters - Local signs like-swelling, bleeding from wound, cellulitis, coagulative parameters like-BT, PT, APTT, INR>1.5, clotting time, D-DIMER and low BP have emerged out to have significant association with AKI after snake bite. [ABSTRACT FROM AUTHOR]