Clinical Assessment and Pathophysiology of Venom-related Acute Kidney Injury: a Scoping Review

Overview

Journal J Venom Anim Toxins Incl Trop Dis

Date 2020 Jul 25

PMID 32704246

Citations 15

Authors

Polianna Lemos Moura Moreira Albuquerque

Jose Hicaro Hellano Goncalves Lima Paiva

Alice Maria Costa Martins

Gdayllon Cavalcante Meneses

Geraldo Bezerra da Silva

Nicholas Buckley

Elizabeth De Francesco Daher

Affiliations

Soon will be listed here.

Abstract

are one of the most common medically important snakes found in Latin America. Its venom is predominantly hemotoxic and proteolytic, which means that local lesion (edema and redness) and hemorrhagic symptoms are recurrent in envenoming by this snake. Although hemorrhage is usually the major cause of death, snakebite-related acute kidney injury is another potentially fatal clinical complication that may lead to chronic kidney disease. The present review highlights the main studies on venom-related acute kidney injury, including observational, cross-sectional, case-control and cohort human studies available up to December 2019. The following descriptors were used according to Medical Subject Headings (MeSH): on Medline/Pubmed and Google Scholar "acute kidney injury" "kidney disease" ""; on Lilacs and SciELO "kidney disease" "acute kidney injury" "". Newcastle-Ottawa quality assessment scale was used to appraise the quality of the cross-sectional and cohort studies included. The selection of more severe patients who looked for health care units and tertiary centers is a risk of bias. Due to the methodological heterogeneity of the studies, a critical analysis of the results was performed based on the hypothesis that the design of the included studies influences the incidence of acute kidney injury. Fifteen human studies (total participants 4624) were included according to stablished criteria. The coagulation abnormalities (hemorrhagic symptoms, abnormal fibrinogen and activated partial thromboplastin time) were associated with acute kidney injury in the most recent studies reported. The findings observed in this review provide up-to-date evidence about the acute kidney injury pathogenesis following syndrome. Studies pointed out that coagulation abnormalities comprise the major pathway for acute kidney injury development. This review may improve patient management by primary healthcare providers, allowing earlier diagnosis and treatment of venom-related acute kidney injury.

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