Complicaciones renales y accidente ofídico por víboras del género Bothrops: Revisión sistemática.

ABSTRACT: Background. Understanding renal complications (acute kidney injury) after snakebite has been limited due to the scarcity of available evidence. The studies conducted so far are predominantly small and observational, and many of them only identify a single event related to envenomation, making it difficult to accurately determine the frequency of renal complications in this scenario. In Brazil, snakebite can cause acute kidney injury in 8-43% of envenomed patients, with approximately 15% of these patients requiring renal replacement therapy (RRT) and a mortality rate of 8-39%. On the other hand, in Colombia, the incidence of this injury is unknown, with the only local data coming from a retrospective cohort study conducted in the 1990s in the city of Medellín, where acute kidney injury was present in 38.5% of the patients. These data confirm that acute kidney injury is a significant cause of morbidity associated with snakebite. Objective. To gather existing literature regarding acute renal complications in the context of Bothropic snakebite accidents. Methods. Systematic review following the PRISMA guidelines, with 12 search strategies across five databases. Exhaustiveness, reproducibility, and methodological quality were ensured. Selection criteria. Published studies without restriction on years or languages, experimental and observational studies in a population aged 18 to 75 years, relating acute kidney injury to snakebite accidents. Data collection and analysis. Data were extracted by two reviewers, with a third reviewer to resolve discrepancies. A descriptive synthesis of the findings was performed after article selection. Results. It was observed that 15.2% of patients with snakebite accidents primarily caused by snakes of the Bothrops sp. genus developed acute kidney injury (AKI). This is consistent with the prevalence of AKI reported in the literature, which ranges from 10% to 29% for Bothrops sp. Furthermore, a significant association was found between acute kidney injury (AKI) and elevated levels of lactate dehydrogenase (LDH). Additionally, it was observed that local bleeding was an intermediate variable associated with acute renal injury. These findings suggest that the presence of hemorrhagic abnormalities and elevated LDH levels may be related to the development of AKI in the context of Bothrops snakebite. Conclusion. The results of the reviewed studies indicate that the severity of envenomation and infection are not directly related to a higher risk of renal complications in snakebite accidents caused by snakes of the genus Bothrops sp. However, it was found that advanced age, hemorrhagic manifestations, and elevated levels of LDH may be associated factors.

• Autores: Castaño Hernández, Ingrid Tatiana; Berbeo Velásquez, Manuel Alejandro
• Tipo de recurso: Tesis
• Fecha de publicación: 2023
• Institución: Universidad de Antioquia
• Repositorio: Repositorio UdeA
• Idioma: spa
• OAI Identifier: oai:bibliotecadigital.udea.edu.co:10495/39899
• Acceso en línea: https://hdl.handle.net/10495/39899
• Palabra clave: Mordeduras de serpientes; Snake Bites; Lesion renal aguda; Acute Kidney Injury; Bothrops; https://id.nlm.nih.gov/mesh/D012909; https://id.nlm.nih.gov/mesh/D058186; https://id.nlm.nih.gov/mesh/D017837
• Rights: embargoedAccess
• License: https://creativecommons.org/licenses/by-nc-nd/4.0/