{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T13:20:17Z","timestamp":1787836817532,"version":"build-2784847793"},"reference-count":25,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T00:00:00Z","timestamp":1787788800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Snakebite envenomation is a major cause of acute kidney injury (AKI) in tropical regions. While acute tubular necrosis (ATN) and acute cortical necrosis have traditionally been described as predominant renal lesions, multiple factors, including recent improvements in early access to antivenom, may have altered the histopathological spectrum. This study aimed to evaluate renal histopathology in snakebite envenomation-associated AKI (SBE-AKI) and its clinicopathological correlates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this prospective observational study conducted at a tertiary care centre in South India from September 2022 to July 2024, patients with proven haemotoxic snake envenomation who developed persistent AKI were included. Kidney biopsies were performed in survivors after correction of coagulopathy, and autopsy biopsies were obtained from non-survivors. Histopathological assessment was independently performed by two blinded pathologists.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Eighteen renal biopsy samples were analysed. ATN and acute interstitial nephritis (AIN) were the most frequent lesions (each 38.9%), followed by thrombotic microangiopathy (16.7%) and pigment nephropathy (5.5%). Notably, no cases of cortical necrosis were identified. Early recognition and treatment of AIN with corticosteroids were associated with complete renal recovery in selected survivors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The predominance of AIN and absence of cortical necrosis suggest an evolving histopathological pattern of SBE-AKI. Early renal biopsy may help identify potentially reversible lesions and improve renal outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/trstmh\/trag099","type":"journal-article","created":{"date-parts":[[2026,8,8]],"date-time":"2026-08-08T11:51:22Z","timestamp":1786189882000},"source":"Crossref","is-referenced-by-count":0,"title":["Renal histopathology in acute kidney injury following haemotoxic snake envenomation"],"prefix":"10.1093","author":[{"given":"P Sai Kameshwar","family":"Rao","sequence":"first","affiliation":[{"name":"Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) Department of Medicine, , Puducherry 605006 ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8391-4419","authenticated-orcid":false,"given":"Chanaveerappa","family":"Bammigatti","sequence":"additional","affiliation":[{"name":"Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) Department of Medicine, , Puducherry 605006 ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P S","family":"Priyamvada","sequence":"additional","affiliation":[{"name":"Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) Department of Nephrology, , Puducherry 605006 ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bheemanathi Hanuman","family":"\u00a0Srinivas","sequence":"additional","affiliation":[{"name":"Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) Department of Pathology, , Puducherry 605006 ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,8,27]]},"reference":[{"key":"2026082708440937000_bib1","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1111\/j.1365-3156.2005.01535.x","article-title":"Clinical predictors of in-hospital mortality in patients with snake bite: A retrospective study from a rural hospital in central India","volume":"11","author":"Kalantri","year":"2006","journal-title":"Trop Med Int Health"},{"key":"2026082708440937000_bib2","first-page":"404","article-title":"Acute renal failure in snake envenomation: A large prospective study","volume":"19","author":"Athappan","year":"2008","journal-title":"Saudi J Kidney Dis Transplant"},{"key":"2026082708440937000_bib3","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1136\/postgradmedj-2011-130225","article-title":"Chronic kidney disease in snake envenomed patients with acute kidney injury in Sri Lanka: A descriptive study","volume":"88","author":"Herath","year":"2012","journal-title":"Postgrad Med J"},{"key":"2026082708440937000_bib4","doi-asserted-by":"crossref","first-page":"271","DOI":"10.3109\/0886022X.2011.647297","article-title":"Long-term renal outcome of snake bite and acute kidney injury: A single-center experience","volume":"34","author":"Waikhom","year":"2012","journal-title":"Ren Fail"},{"key":"2026082708440937000_bib5","doi-asserted-by":"crossref","first-page":"564","DOI":"10.1093\/ckj\/sfz055","article-title":"Prognosis and long-term outcomes of acute kidney injury due to snake envenomation","volume":"13","author":"Priyamvada","year":"2019","journal-title":"Clin Kidney J"},{"key":"2026082708440937000_bib6","doi-asserted-by":"crossref","first-page":"e006497","DOI":"10.1136\/bmjopen-2014-006497","article-title":"Long-term prognosis after acute kidney injury (AKI): What is the role of baseline kidney function and recovery? 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