Long-Term Kidney Outcomes Following Snake Envenomation: The Role of Snakebite-Related Acute Kidney Injury in a Nationwide Korean Cohort

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  Long-Term Kidney Outcomes Following Snake Envenomation: The Role of Snakebite-Related Acute Kidney Injury in a Nationwide Korean Cohort Abstract Long-term renal outcomes following snake envenomation may vary across regions, yet remain poorly characterized in South Korea. We investigated the long-term risk of chronic kidney disease (CKD) following snake envenomation and snakebite-related acute kidney injury (AKI). This nationwide population-based cohort study used data from the Korean National Health Information Database (2012–2023). We matched 729 adults hospitalized for snake envenomation who received antivenom to 2916 individuals without snake envenomation (1:4). Using a 1-year landmark design, we assessed incident CKD with Cox proportional hazards models and Kaplan–Meier analysis. CKD occurred in 48 patients with snake envenomation and in 156 controls, with incidence rates of 7.16 and 5.59 per 1000 person-years, respectively. Snake envenomation was not significantly associated...

Chronic health manifestations following hump-nosed pit viper (Hypnale spp.) bites: an authenticated case series

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By Buddhika.jm (Buddhika Mawella) - Own work, CC BY-SA 4.0, https://commons.wikimedia.org/w/index.php?curid=56418341

Chronic health manifestations following hump-nosed pit viper (Hypnale spp.) bites: an authenticated case series

Background

Hump-nosed pit vipers (genus Hypnale) are the most common cause of venomous snakebites in Sri Lanka, accounting for more than one-third of all snakebites, as they are widely distributed throughout the country. It is a highly medically important snake in Sri Lanka. Even though several life-threatening complications, including venom-induced consumption coagulopathy, acute kidney injury, venom-induced thrombotic microangiopathy and cardiac effects, are reported following their bites, no antivenom is currently available for Hypnale - envenomed patients either in Sri Lanka or India. Apart from the acute manifestations of snakebites, chronic health effects have rarely been described in the literature.

Methods

A case series of 11 patients who developed long-term health effects following hump-nosed pit viper bites was prospectively studied at the Teaching Hospital, Ratnapura, Sri Lanka, from June 2015 to May 2021. Data on clinical presentation, examination findings, investigations, management and two-year follow-up were collected.

Results

This case series describes some of the chronic health manifestations following hump-nosed pit viper bites in 11 patients, including chronic kidney disease, fasciotomy-related injuries, musculoskeletal disabilities and pulmonary effects.

Conclusion

Hump-nosed pit viper bites can cause severe long-term sequelae that require follow-up. Physicians should be aware of these manifestations when managing patients and this case series highlights the need for an effective antivenom for Hypnale bites.

Rathnayaka, R. M., Ranathunga, P. E., & Kularatne, S. A. Chronic health manifestations following hump-nosed pit viper (Hypnale spp.) bites: An authenticated case series. Transactions of The Royal Society of Tropical Medicine and Hygiene. https://doi.org/10.1093/trstmh/traf148