Renal ischaemia, transient glomerular leak and acute renal tubular damage in patients envenomed by Russell's vipers (Daboia russelii siamensis) in Myanmar.

Journal article

Fifty-two patients who had been bitten by Russell's vipers in Myanmar developed acute renal failure (serum creatinine exceeding 1.3 mg/dL). Thirty-four of them (65%) became oliguric, but the other 18 (35%) maintained a urine output of more than 400 mL/24 h. In oliguric patients, gastrointestinal haemorrhages, renal angle tenderness and conjunctival oedema occurred more commonly, and peak serum creatinine, blood urea nitrogen and the fractional excretion of sodium were significantly higher (P < 0.01) than in non-oliguric patients, indicating a greater degree of renal damage. Urinary concentrations of beta 2 microglobulin and retinol binding protein were raised in most of the patients indicating failure of proximal tubular reabsorption of these proteins, while high urinary N-acetyl glucosaminidase concentrations were consistent with renal tubular damage. Plasma concentrations of active renin were very high, suggesting that renal ischaemia, associated with activation of the renin-angiotensin system, was involved in the development of renal dysfunction.

Authors: Tin-Nu-Swe; Tin-Tun; Myint-Lwin; Thein-Than; Tun-Pe

• Publication status: Published
• Journal: Transactions of the Royal Society of Tropical Medicine and Hygiene
• Volume: 87
• Issue: 6
• Pages: 678-681
• Publication date: 1993-01-01
• DOI: 10.1016/0035-9203(93)90290-7
• EISSN: 1878-3503
• ISSN: 0035-9203
• Language: English
• Keywords: Acute Kidney Injury; Male; Adult; Oliguria; Viper Venoms; Conjunctival Diseases; Russell's Viper; Edema; Ischemia; Prospective Studies; Female; Humans; Snake Bites; Kidney; Animals