Skip to main content
SpringerLink
Log in

Snakebites Accidents and Renal Complications

  • Chapter
  • First Online:
Tropical Nephrology

  • 318 Accesses

Abstract

Acute kidney injury (AKI) is a common systemic complication after snakebites. The complications are associated with the high lethality among the victims. The pathogenesis of this type of AKI has yet to be fully elucidated. Some studies have proposed a multifactorial origin, while the triggering factors may act in combination. The mechanisms involved are hemodynamic disorders, immunological reactions, and the nephrotoxic action of the venom itself. Hemolysis and hematuria are involved in the kidney injury process through the deposition and accumulation of hemoglobin and myoglobin cylinders, causing obstruction and induction of vasoconstriction, culminating in ischemia and AKI. Acute tubular necrosis and acute interstitial nephritis are the most common anatomopathological injuries seen in snakebite accidents and may be reversed.

AKI diagnosis is usually established within the first 24–48 hours. Antivenom administration that is performed more than 2 hours after the accident is associated with a higher risk of developing complications, such as AKI, intracranial hemorrhage, and death.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 139.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Warrell D. Snake bite. Lancet. 2010;375:77–88.

    Article  PubMed  Google Scholar 

  2. Kasturiratne A, Wickremasinghe A, De Silva N, Gunawardena N, Pathmeswaran A, Premaratna R, et al. The global burden of snakebite: a literature analysis and modelling based on regional estimates of envenoming and deaths. PLoS Med. 2008;5(11):1591–604.

    Article  Google Scholar 

  3. Chippaux J-P. Guidelines for the production, control and regulation of snake antivenom immunoglobulins. Biol Aujourdhui. 2010;204:87–91.

    Article  PubMed  Google Scholar 

  4. Cardoso J. Acidentes por Animais Peçonhentos na Coordenação de Zoonoses e Animais Peçonhentos - Comentários e Sugestões. Brasília: Ministério da Saúde (mimeo.); 1993.

    Google Scholar 

  5. de Oliveira RC, Wen FH, Sifuentes DN. Epidemiologia dos acidentes por animais peçonhentos. In: Cardoso JLC, França FOS, Wen FH, Malaque CMS, Haddad Jr V, editors. Animais peçonhentos no Brasil: biologia, clínica e terapêutica dos acidentes. 2nd ed. São Paulo: Sarvier; 2009. p. 6–21.

    Google Scholar 

  6. Bochner R, CJ S. Acidentes por animais peçonhentos e sistemas nacionais de informação: recording of venomous bites and stings by National Information Systems in Brazil. Cad Saude Publica. 2002;18:735–46.

    Article  PubMed  Google Scholar 

  7. SINAN. Acidentes por animais peçonhentos: notificações registradas no Sistema de Informação de Agravos de Notificação. 2015.

    Google Scholar 

  8. Warrell D. Venomous bites, stings, and poisoning. Infect Dis Clin N Am. 2012;26:207–23.

    Article  Google Scholar 

  9. Gutiérrez J, Theakston R, Warrell D. Confronting the neglected problem of snake bite envenoming: the need for a global partnership. PLoS Med. 2006;3(6):e150.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Chippaux J. Epidemiology of envenomations by terrestrial venomous animals in Brazil based on case reporting: from obvious facts to contingencies. J Venom Anim Toxins Incl Trop Dis. 2015;21(1):1–17.

    Article  CAS  Google Scholar 

  11. Brasil. Manual de diagnóstico e tratamento de acidentes por animais peçonhentos. Brasília: Ministério da Saúde. Secretaria de Vigilância em Saúde. Departamento de Vigilância Epidemiológica; 2001. 120 p.

    Google Scholar 

  12. Franco F. Origem e Diversidade das Serpentes. In: Cardoso J, França FOS, Wen FH, Málaque C, Haddad VJ, editors. Animais Peçonhentos no Brasil: Biologia, Clínica e Terapêutica dos Acidentes. 2nd ed. São Paulo: Sarvier; 2009. p. 22–41.

    Google Scholar 

  13. Warrell DA. Guidelines for the management of snake-bites. New Delhi: World Health Organization, 2010, 162p. Available at: https://apps.searo.who.int/PDS_DOCS/B4508.pdf.

  14. Serpentes MA. Peçonhentas do Brasil. In: Animais Peçonhentos no Brasil: Biologia, Clínica e Terapêutica dos Acidentes. 2nd ed. São Paulo: Sarvier; 2009. p. 43–70.

    Google Scholar 

  15. Otero R, Gutiérrez J, Beatriz Mesa M, Duque E, Rodríguez O, Luis Arango J, et al. Complications of Bothrops, Porthidium, and Bothriechis snakebites in Colombia. A clinical and epidemiological study of 39 cases attended in a university hospital. Toxicon. 2002;40(8):1107–14.

    Article  CAS  PubMed  Google Scholar 

  16. Wen F, Monteiro W, Moura da Silva A, Tambourgi D, Mendonça da Silva I, Sampaio V, et al. Snakebites and scorpion stings in the Brazilian Amazon: identifying research priorities for a largely neglected problem. PLoS Negl Trop Dis. 2015;9(5):1–11.

    Google Scholar 

  17. Sousa L, Nicolau C, Peixoto P, Bernardoni J, Oliveira S, Portes-Junior J, et al. Comparison of phylogeny, venom composition and neutralization by Antivenom in diverse species of Bothrops Complex. PLoS Negl Trop Dis. 2013;7(9):1–16.

    Article  CAS  Google Scholar 

  18. Cunha E, Martins O. Principais compostos químicos presente nos venenos de cobras dos gêneros Bothrops e Crotalus – Uma Revisão. Rev Eletrônica Educ e Ciência. 2012;02(2):21–6.

    Google Scholar 

  19. Pardal PPO, Souza SM, Monteiro MRCC, França FOS, Tomy SC, Sano-Martins IS, et al. Clinical trial of two antivenoms for the treatment of Bothrops and Lachesis bites in the north eastern Amazon region of Brazil. Trans R Soc Trop Med Hyg. 2004;98:28–42.

    Article  CAS  PubMed  Google Scholar 

  20. Luciano P, Silva G, Azevedo-Marques M. Acidente botrópico fatal. Med (Ribeirão Preto). 2009;42(1):61–5.

    Article  Google Scholar 

  21. Gutiérrez JM, Rucavado A, Escalante T, Díaz C. Hemorrhage induced by snake venom metalloproteinases: biochemical and biophysical mechanisms involved in microvessel damage. Toxicon. 2005;45:997–1011.

    Article  PubMed  CAS  Google Scholar 

  22. Pardal PPO, Silva CLQ, Hoshino SSN, Pinheiro FR. Acidente por cascavel (Crotalus sp) em Ponta de Pedras, Ilha do Marajó, Pará- Relato de Caso. Resist Para Med. 2007;20(2):51–6.

    Google Scholar 

  23. Caiaffa W, Vlahov D, Antunes C, de Oliveira H, Diniz C. Snake bite and antivenom complications in Belo Horizonte, Brazil. Trans R Soc Trop Med Hyg. 1994;88(1):81–5.

    Article  CAS  PubMed  Google Scholar 

  24. Azevedo-Marques M, Cupo P, SE H. Acidentes por animais peçonhentos: Serpentes Peçonhentas. Med Ribeirão Preto. 2003;36(1):480–9.

    Google Scholar 

  25. Damico DCS, Bueno LGF, Rodrigues-Simioni L, Maangoni S, Cruz-Hofling MA, Novello JC. Functional characterization of a basic D49 phospholipase A2 (LmTX-I) from the venom of the snake Lachesis muta muta (bushmaster ). Toxicon. 2006;47:759–65.

    Article  CAS  PubMed  Google Scholar 

  26. Diniz M, Oliveira E. Purification and properties of a kininogenin from the venom of Lachesis muta (bushmaster). Toxicon. 1992;30(3):247–58.

    Article  CAS  PubMed  Google Scholar 

  27. Silva N Jr, Bucaretchi F. Mecanismo de ação do veneno elapídico e aspectos clínicos dos acidentes. In: Animais Peçonhentos do Basil - Biologia, Clínica e terapêutica dos Acidentes. 2nd ed. São Paulo: Sarvier; 2009. p. 116–24.

    Google Scholar 

  28. Pardal P, Pardal J, Gadelha M, Rodrigues L, Feitosa D, Prudente A, et al. Envenomation by Micrurus coral snakes in the Brazilian Amazon region: report of two cases. Rev Inst Med Trop Sao Paulo. 2010;52(6):333–7.

    Article  PubMed  Google Scholar 

  29. Barros A, Fernandes D, Ferreira L, Dos Santos M. Local effects induced by venoms from five species of genus Micrurus sp. (coral snakes). Toxicon. 1994;32(4):445–52.

    Article  CAS  PubMed  Google Scholar 

  30. Borges C, Sadahiro M, dos Santos M. Aspectos epidemiológicos e clínicos dos acidentes ofídicos ocorridos nos municípios do Estado do Amazonas Epidemiological and clinical aspects of snake accidentes in the municipalities of the State of Amazonas. Brazil Rev Soc Bras Med Trop. 1999;32(6):637–46.

    Article  Google Scholar 

  31. Brasil. Acidentes por animais peçonhentos. In: Saúde M da SS de V em, editor. Guia de vigilância epidemiológica. 7a ed. Brasília; 2009. p. 1–6.

    Google Scholar 

  32. Moreira V, Dos-Santos M, Nascimento N, da Silva H, Fernandes C, D’Império Lima M, et al. Local inflammatory events induced by Bothrops atrox snake venom and the release of distinct classes of inflammatory mediators. Toxicon. 2012;60(1):12–20.

    Article  CAS  PubMed  Google Scholar 

  33. Cruz L, Vargas R, Lopes A. Snakebite envenomation and death in the developing world. Ethn Dis. 2009;19(1):42–6.

    Google Scholar 

  34. Oliveira F, Brito M, de Morais I, Fook S, de Albuquerque H. Accidents caused by Bothrops and Bothropoides in the state of Paraiba: epidemiological and clinical aspects. Rev Soc Bras Med Trop. 2010;43(6):662–7.

    Article  PubMed  Google Scholar 

  35. Mourão-de-Moura V, Mourão RH, Dos-Santos M. Acidentes ofídicos na Região Norte do Brasil e o uso de espécies vegetais como tratamento alternativo e complementar à soroterapia. Sci Amaz. 2015;4(1):73–84.

    Article  Google Scholar 

  36. Ribeiro L, Jorge M. Acidente por serpentes do gênero Bothrops: série de 3.139 casos. Rev Soc Bras Med Trop. 1997;30(6):475–80.

    Article  CAS  PubMed  Google Scholar 

  37. Jorge M, Ribeiro L. Epidemiologia e quadro clínico do acidente por cascavel Sul-Americana (Crotalus durussis). Rev Inst Med trop São Paulo. 1992;34(4):347–54.

    Article  CAS  PubMed  Google Scholar 

  38. Lima P, Haddad JV. Case report a snakebite caused by a bushmaster (Lachesis muta): report of a confirmed case in state of Pernambuco. Brazil. Rev Soc Bras Med Trop. 2015;48(5):636–7.

    Article  PubMed  Google Scholar 

  39. Feitosa E, Sampaio V, Salinas J, Queiroz A, da Silva I, Gomes A, et al. Older age and time to medical assistance are associated with severity and mortality of snakebites in the Brazilian Amazon: a case-control study. PLoS One. 2015;10(7):1–15.

    Article  CAS  Google Scholar 

  40. Pardal PP. De Oliveira; Bezerra, Ismael Silva; Rodrigues, Liliam da Silva; Pardal, Joseana Silva de Oliveira; Farias PHS. Acidente por Surucucu (Lachesis muta muta) em Belém-Pará: Relato de Caso. Rev Para Med. 2007;21(1):37–42.

    Google Scholar 

  41. Casais-e-Silva L, Brazil T. Acidentes elapídicos no estado da Bahia: Estudo retrospectivo dos aspectos epidemiológicos em uma serie de 14 anos (1980-1993). Gaz Médica da Bahia. 2009;79(1):26–31.

    Google Scholar 

  42. Brasil. Acidentes por Animais Peçonhentos. In: Saúde M da SS de V em, editor. Guia de Vigilância em Saúde. 1a ed. Brasília; 2014. p. 720–723.

    Google Scholar 

  43. Wen FH. Soroterapia. In: Cardoso JLC, França FOS, Wen FH, Málaque CMS, Haddad Jr V, editors. Animais Peçonhentos no Brasil: Biologia, Clínica e Terapêutica dos Acidentes. 2nd ed. São Paulo: Sarvier; 2003. p. 432–41.

    Google Scholar 

  44. Fan HW, Marcopito LF, Cardoso JL, França FO, Malaque CM, Ferrari RA, et al. Sequential randomised and double blind trial of promethazine prophylaxis against early anaphylactic reactions to antivenom for Bothrops snake bites. BMJ. 1999;318(7196):1451–2.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  45. Albuquerque P, Jacinto CN, Silva Junior G, Lima J, Veras M, Daher E. Acute kidney injury caused by Crotalus and Bothrops snake venom: a review of epidemiology, clinical manifestations and treatment. Rev Inst Med Trop Sao Paulo. 2013;55(5):295–301.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Moreno E, Queiroz-Andrade M, Lira-da-Silva R, Tavares-Neto J. Clinical and epidemiological characteristics of snakebites in Rio Branco. Acre Rev Soc Bras Med Trop. 2005;38(1):15–21.

    Article  PubMed  Google Scholar 

  47. Cupo P, Azevedo-Marques M, De Menezes J, Hering S. Reações de hipersensibilidade imediatas apos uso intravenoso de soros antivenenos: Valor prognostico dos testes de sensibilidade intradermicos. Revista do Instituto de Medicina Tropical de Sao Paulo. 1991. p. 115–22.

    Google Scholar 

  48. Pinho F, Oliveira E, Faleiros F. Acidente ofídico no estado de Goiás. Rev Assoc Med Bras. 2004;50(1):93–6.

    Article  PubMed  Google Scholar 

  49. Danis R, Ozmen S, Celen M, Akin D, Ayaz C, Yazanel O. Snakebite-induced acute kidney injury: data from Southeast Anatolia. Ren Fail. 2008;30:51–5.

    Article  CAS  PubMed  Google Scholar 

  50. Athappan G, Balaji M, Navaneethan U. Thirumalikolundusubramanian P. acute renal failure in Snake envenomation: a large prospective study. Saudi J Kidney Dis Transplant. 2008;19(3):404–10.

    Google Scholar 

  51. Kanjanabuch T, Sitprija V. Snakebite nephrotoxicity in Asia. Semin Nephrol. 2008;28(4):363–72.

    Article  PubMed  Google Scholar 

  52. Pinho F, Yu L, Burdmann E. Epidemiology of acute kidney injury in Latin America. Semin Nephrol. 2008;28(4):354–62.

    Article  PubMed  Google Scholar 

  53. Chugh K, Pal Y, Chakravarty R, Datta B, Mehta R, Sakhuja V, et al. Acute renal failure following poisonous snakebite. Am J Kidney Dis. 1984;4(1):30–8.

    Article  CAS  PubMed  Google Scholar 

  54. Albuquerque P, Silva Junior G, Jacinto C, Lima J, Lima C, Amaral Y, et al. Acute kidney injury after snakebite accident treated in a tertiary care Centre. Nephrology. 2014;19(12):1–23.

    Article  Google Scholar 

  55. Sgrignolli L, Mendes G, Carlos C, Burdmann E. Acute kidney injury caused by Bothrops snake venom. Nephron - Clin Pract. 2011;119(2):131–8.

    Article  CAS  Google Scholar 

  56. De Castro I, Burdmann E, Seguro A, Yu L. Bothrops venom induces direct renal tubular injury: role for lipid peroxidation and prevention by antivenom. Toxicon. 2004;43(7):833–9.

    Article  PubMed  CAS  Google Scholar 

  57. Athappan G, Balaji M, Navaneethan U. Thirumalikolundusubramanian P. of kidney diseases and transplantation original article acute renal failure in Snake envenomation: a large prospective study. Saudi J Kidney Dis Transplant. 2008;19(3):404–10.

    Google Scholar 

  58. Lameire N, Biesen W, Vanholder R. Acute renal failure. Lancet. 2005;365:417–30.

    Article  CAS  PubMed  Google Scholar 

  59. Barbosa PSF, Havt A, Facó PEG, Sousa TM, Bezerra ISAM, Fonteles MC, et al. Renal toxicity of Bothrops moojeni snake venom and its main myotoxins. Toxicon. 2002;40(10):1427–35.

    Article  CAS  PubMed  Google Scholar 

  60. Santos M, Farani M, Rocha P. Insuficiência renal aguda em acidentes ofídicos por Bothrops sp. e Crotalus sp.: revisão e análise crítica da literatura. J Bras Nefrol. 2009;31(2):132–8.

    Google Scholar 

  61. Karthik S, Phadke K. Snakebite-induced acute renal failure. A case report and review of the literature. Pediatr Nephrol. 2004;19(9):1053–4.

    Article  PubMed  Google Scholar 

  62. Souza A. Acidente por serpente Bothrops atrox (LIN. 1758) no estado do Amazonas: Estudo de 212 casos com identificação da serpente. Rev Patol Trop. 2002;31(2):259–68.

    Google Scholar 

  63. Quino H, Velázques M, Hurtado M, Urcia J, Hurtado A. Ofidismo y Falla Renal. Boletín Soc Peru Med Interna. 1995;8(23):23–6.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Nursing School, State University of Amazonas, Manaus, Amazonas, Brazil

    Jacqueline de Almeida Gonçalves Sachett

  2. Post-Graduation Program in Tropical Diseases, Tropical Medicine Foundation Dr. Heitor Vieira Dourado, Manaus, Amazonas, Brazil

    Sâmella Silva de Oliveira

  3. Division of Nephrology, Tropical Medicine Foundation Dr. Heitor Vieira Dourado, Manaus, Amazonas, Brazil

    Valquir Silva dos Santos

  4. Post Graduation Programs in Tropical Medicine and Health Sciences, Tropical Medicine Foundation Dr. Heitor Vieira Dourado, Manaus, Amazonas, Brazil

    Vanderson de Souza Sampaio

  5. Department of Endemic Diseases, State Health Surveillance Foundation of Amazonas, Manaus, Amazonas, Brazil

    Vanderson de Souza Sampaio

  6. Post-Graduation Program in Tropical Medicine, Tropical Medicine Foundation Dr. Heitor Vieira Dourado, State University of Amazonas, Manaus, Amazonas, Brazil

    Wuelton Marcelo Monteiro & Marcus Vinícius Guimarães de Lacerda

Authors
  1. Jacqueline de Almeida Gonçalves Sachett
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sâmella Silva de Oliveira
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Valquir Silva dos Santos
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Vanderson de Souza Sampaio
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Wuelton Marcelo Monteiro
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Marcus Vinícius Guimarães de Lacerda
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. University of Fortaleza, Fortaleza, Ceará, Brazil

    Geraldo Bezerra da Silva Junior

  2. Federal University of Ceará, Fortaleza, Ceará, Brazil

    Elizabeth De Francesco Daher

  3. Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil

    Elvino Barros

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

de Almeida Gonçalves Sachett, J., de Oliveira, S.S., dos Santos, V.S., de Souza Sampaio, V., Monteiro, W.M., de Lacerda, M.V.G. (2020). Snakebites Accidents and Renal Complications. In: Bezerra da Silva Junior, G., De Francesco Daher, E., Barros, E. (eds) Tropical Nephrology. Springer, Cham. https://doi.org/10.1007/978-3-030-44500-3_3

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-44500-3_3

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-44499-0

  • Online ISBN: 978-3-030-44500-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation