{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T07:05:06Z","timestamp":1784185506771,"version":"3.55.0"},"reference-count":13,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"vor","delay-in-days":195,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["International Journal of Nephrology"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Snakebite is a neglected tropical disease with a high burden in South Asia, particularly India. Acute kidney injury (AKI) is one of the most serious complications of snake envenomation, which has significant morbidity, mortality, and risk of chronic kidney disease (CKD). The present study aimed to evaluate the incidence, predictors, and outcomes of snakebite\u2010associated AKI (SBE\u2010AKI) in a tertiary care center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed 325 patients with snakebite envenomation, admitted to our institution. Demographic, clinical, laboratory, and treatment variables were compared between patients with and without AKI. AKI was staged according to KDIGO criteria. Renal biopsy was performed selectively in patients with prolonged renal failure, dialysis dependence, delayed renal recovery, or suspicion of irreversible renal injury. Outcomes assessed included recovery, progression to CKD, and mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the 325 patients, 79 (32.1%) developed AKI. Patients with AKI were significantly younger (mean age 34 vs. 45\u2009years,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.001). Delay in antisnake venom (ASV) administration (5 vs. 9\u2009h,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.001), need for inotropes (41.8% vs. 14.2%,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.001), and mechanical ventilation (36.7% vs. 6.9%,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.001) were strong predictors. Proteinuria was more frequent in AKI (80% vs. 32.5%). Among AKI patients, 57% had Stage 3 AKI; 39.2% required dialysis. Biopsy (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20098) showed acute tubular necrosis in 37.5% and cortical necrosis in 25%. Outcomes included 77.2% recovery, 6.3% progression to CKD, and 16.5% mortality.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>SBE\u2010AKI is a common and serious complication of snakebite. Delay in ASV administration, hemodynamic instability, proteinuria, advanced AKI stage, and cortical necrosis predict poor outcomes. Early ASV, timely dialysis, and long\u2010term nephrology follow\u2010up are essential to improve survival and reduce CKD progression.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/ijne\/6661125","type":"journal-article","created":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T06:27:40Z","timestamp":1784183260000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Profile and Outcome of Snake Bite\u2013Associated Acute Kidney Injury: A Retrospective Study"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3948-2062","authenticated-orcid":false,"given":"E.","family":"Mahesh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1805-5387","authenticated-orcid":false,"given":"Mohammed","family":"Yousuff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5906-6440","authenticated-orcid":false,"given":"N.","family":"Monika","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4287-3945","authenticated-orcid":false,"given":"Pooja","family":"Prabhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4769-5749","authenticated-orcid":false,"given":"M. S.","family":"Gireesh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9082-8757","authenticated-orcid":false,"given":"R.","family":"Rajashekar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V.","family":"Hamsa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,15]]},"reference":[{"key":"e_1_2_12_1_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.0050218"},{"key":"e_1_2_12_2_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0001018"},{"key":"e_1_2_12_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/trstmh\/trae114"},{"key":"e_1_2_12_4_2","doi-asserted-by":"publisher","DOI":"10.5527\/wjn.v6.i3.150"},{"key":"e_1_2_12_5_2","doi-asserted-by":"publisher","DOI":"10.7860\/JCDR\/2013\/5495.2957"},{"key":"e_1_2_12_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1797.2006"},{"key":"e_1_2_12_7_2","doi-asserted-by":"publisher","DOI":"10.1136\/postgradmedj-2011-130225"},{"key":"e_1_2_12_8_2","volume-title":"Guidelines for the Management of Snake-Bites","author":"Warrell D. A.","year":"2016"},{"key":"e_1_2_12_9_2","doi-asserted-by":"publisher","DOI":"10.1038\/ki.1989.70"},{"key":"e_1_2_12_10_2","first-page":"332","article-title":"Snake Bite-Induced Acute Kidney Injury: A Comprehensive Clinical and Histopathological Study","volume":"26","author":"Dhanapriya J.","year":"2016","journal-title":"Indian Journal of Nephrology"},{"key":"e_1_2_12_11_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.1.5336.992"},{"key":"e_1_2_12_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/ckj\/sfaa168"},{"key":"e_1_2_12_13_2","first-page":"2026","article-title":"Clinical Profile and Outcome of Snake Bite Associated Acute Kidney Injury-A Retrospective Study","author":"Mahesh E.","year":"2026","journal-title":"MedRxiv"}],"container-title":["International Journal of Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/ijne\/6661125","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/ijne\/6661125","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/ijne\/6661125","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T06:27:42Z","timestamp":1784183262000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/ijne\/6661125"}},"subtitle":[],"editor":[{"given":"Tej K.","family":"Mattoo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":13,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1155\/ijne\/6661125"],"URL":"https:\/\/doi.org\/10.1155\/ijne\/6661125","archive":["Portico"],"relation":{},"ISSN":["2090-214X","2090-2158"],"issn-type":[{"value":"2090-214X","type":"print"},{"value":"2090-2158","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2026-03-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-02","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"6661125"}}