Abstract:
Renal failure remains a serious late complication of snake-bite
envenomation and contributes significantly to mortality. Clinical effects depend
on the degree of envenomatior type of snake and speed of antivenom
administration amongst other factors. The renal effects range from none at all to
proteinuria, mild oliguria, haemoglobinuria, haematuria and severe olio guric
renal failure. Immediate hospitalisation, early and effective antivenom
administration and meticulous attention to fluid and electrolyte balance are
essential measures. Consumption of king-coconut water has been found to make
management difficult. Mannitol challenge and maintaining hydration have helped
to avoid peritoneal dialysis and therefore its hazards. Dialysis therapy when
indicated, careful post dialysis care, aided by renal biopsy when recovery is slow
are measures that are recommended. The role of intravenous heparin needs further
clinical study. In bilateral and diffuse cortical necrosis no renal recovery is
possible and the only mode of therapy would be regular dialysis treatment and
kidney transplantation.
