Acute Kidney Injury Following Snakebite Envenomation: Incidence, Clinical Profile, and Outcomes in a Tertiary Care Hospital in South India

Abstract

Background & Objectives: Snakebite envenomation is a major public health concern in rural India, with acute kidney injury (AKI) being a severe complication associated with significant morbidity and mortality. This study aimed to assess the incidence, clinical characteristics, and prognostic outcomes of AKI in snakebite victims at a tertiary care hospital in South India.
Methods: A prospective observational study was conducted at Government Karur Medical College, Karur, Tamil Nadu, India, from January 2023 to December 2024. We enrolled 120 adult snakebite patients diagnosed with AKI per Acute Kidney Injury Network criteria. Data on demographics, clinical symptoms, laboratory parameters, and treatment outcomes were collected. Outcomes were categorized as recovery, mortality, or progression to chronic kidney disease (CKD). Statistical analysis included Chi-square tests, Fisher’s exact tests, and Student’s t-tests to compare outcomes.
Results: Among 120 patients (68 males, 52 females, mean age 41.5 ± 13.2 years), all had lower limb bites, with viper bites identified in 58 (48.3%). Oliguria occurred in 72 (60%), bleeding tendencies in 80 (66.7%), and haemodynamic instability in 92 (76.7%). Recovery was achieved in 98 (81.7%) patients, 10 (8.3%) died, and 12 (10%) developed CKD. Early antisnake venom (ASV) administration (≤5 hours) significantly improved outcomes (p<0.001). Haemodialysis was required in 20 (16.7%) patients.
Conclusions: Early hospitalization and prompt ASV administration significantly enhance recovery from snakebite-induced AKI. Delayed presentation increases mortality and CKD risk. Strengthened healthcare access and awareness are crucial for better outcomes.