INTRODUCTION: bites in Thailand, identify factors associated with acute kidney injury and hemodialysis, and analyze antivenom administration with reference to acute kidney injury and hemodialysis. METHODS: bites were reviewed. Definite cases were defined when the snake species was identified via a live specimen, carcass, or photograph. RESULTS: A total of 185 patients were included, with 101 definite cases. Most (82.7%) were male, and the mean (±SD) age was 43.0 ± 16.6 years. Overall clinical manifestations included local effects (20.5%), coagulopathy (89.2%), acute kidney injury (50.3%), thrombocytopenia (31.4%), and rhabdomyolysis (28.1%). Antivenom was administered in 89.2% of cases. The median (IQR) length of hospital stay was 5 (3-7) days. The mortality rate was 3.8%. Tachycardia at presentation, initial proteinuria, and rhabdomyolysis were found to prognosticate the development of acute kidney injury. Metabolic acidosis at presentation and rhabdomyolysis were predictors of the requirement for hemodialysis. In addition, receiving antivenom within two hours may reduce the need for hemodialysis (odds ratio 0.153, 95% CI 0.035-0.674). DISCUSSION: bites may have resulted from geographic variation in the venom composition and/or differences in the study period and population. Although antivenom treatment did not reverse renal injury, it may have prevented progression. CONCLUSIONS: bite, and early administration of antivenom may reduce the need for hemodialysis.
Tansuwannarat et al. (Mon,) studied this question.