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Venoms and Toxins

Editor-in-Chief

ISSN (Print): 2666-1217
ISSN (Online): 2666-1225

Mini-Review Article

Hypothetical Interventions to Prevent Acute Kidney Injury After Humpnosed Pit Viper Bite

Author(s): Kolitha Harischandra Sellahewa*

Volume 3, 2023

Published on: 22 September, 2023

Article ID: e270723219163 Pages: 6

DOI: 10.2174/2666121703666230727092454

Price: $65

Abstract

Even though the Hump-nosed pit viper bite is the commonest venomous snake bite in Sri Lanka, antivenoms with specific activity against it are not available. Acute kidney injury (A.K.I.) is an important systemic complication accounting for mortality. Therapeutic plasma exchange (TPE) and fresh frozen plasma (F.F.P.) are two interventional options hypothesized to prevent A.K.I. This is by TPE attenuating venom antigenemia and F.F.P. by inhibiting nephrotoxic renal injury by immunomodulation, and the additional benefit of replenishment of depleted clotting factors triggered by venom-induced consumption coagulopathy implicated in the multifactorial mechanisms of renal injury. Routine interventions on all envenomed patients are not justifiable owing to the rarity and sporadic occurrence of systemic complications, and only patients with coagulopathy should be selected for interventions. The benefit of preventing A.K.I. is most likely with early intervention at the inception of coagulopathy.

Keywords: Hump-nosed viper bite, preventing acute kidney injury, therapeutic plasma exchange, fresh frozen plasma, renal injury, dialysis.


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