Venomous Aftermath: A Case of Chronic Kidney Disease Following a Snake Bite

Authors

  • Revena Astanti Percunda General Practitioner, dr. TC Hillers Maumere Regional Hospital, East Nusa Tenggara, Indonesia https://orcid.org/0000-0002-5980-7947 (unauthenticated)
  • Ni Luh Putu Yunia Dewi General Practitioner, dr. TC Hillers Maumere Regional Hospital, East Nusa Tenggara, Indonesia
  • Stella Pangestika General Practitioner, dr. TC Hillers Maumere Regional Hospital, East Nusa Tenggara, Indonesia
  • Asep Purnama General Practitioner, dr. TC Hillers Maumere Regional Hospital, East Nusa Tenggara, Indonesia

DOI:

https://doi.org/10.15850/ijihs.v14n1.4579

Keywords:

Chronic Kidney Diseases, Renal failure, Snakebite

Abstract

Background: Snakebite remains neglected public health concern in many tropical and subtropical countries. National epidemiological data on snakebite incidence in Indonesia remain limited, and restricted healthcare access often turns snakebite into a medical emergency due to the potential to cause local tissue damage, hemorrhage, respiratory failure, and particularly renal injury.

Objective: To discuss the management of Acute Kidney Injury (AKI) resulting from snakebite that progressed to Chronic Kidney Disease (CKD) in the rural region of Indonesia.

Case: A 45-year-old female patient from Maumere, East Nusa Tenggara, Indonesia, was bitten by an unidentified snake. The patient experienced pain, edema, and visible bite marks on the left leg, but no reported or identified comorbidities. She was hospitalized for 26 days and was diagnosed with snakebite-induced acute kidney injury (AKI). Antivenom, symptomatic treatment, and hemodialysis were administered due to her conditions. The patient was subsequently followed for 3 months and was diagnosed with chronic kidney disease (CKD) secondary to progression of AKI.

Conclusion: In Indonesia, particularly in rural regions such as East Nusa Tenggara, where snakebite cases are common, the establishment of long-term outpatient programs may be essential. Such programs could help manage late complications, including CKD, and enhance outcomes by avoiding hemodialysis and kidney transplantation.

Downloads

Download data is not yet available.

References

World Health Organization. Snakebite envenoming. Geneva: World Health Organization; 2023.

Patikorn C, Blessmann J, Nwe MT, Tiglao PJG, Vasaruchapong T, Maharani T, et al. Estimating economic and disease burden of snakebite in ASEAN countries using a decision analytic model. PLoS Negl Trop Dis. 2022;16(9):e0010775. doi:10.1371/journal.pntd.0010775

Patikorn C, Ismail AK, Abidin SAZ, Blanco FB, Blessmann J, Choumlivong K, et al. Situation of snakebite, antivenom market and access to antivenoms in ASEAN countries. BMJ Glob Health. BMJ Glob Health. 2022;7(3):e007639. doi: 10.1136/bmjgh-2021-007639

Puspaningtyas NW, Dewi R, Imanadhia A. Gigitan ular: manajemen terkini. J Indon Med Assoc. 2022;72(2):97–104. doi: 10.47830/jinma-vol.72.2-2022-386

Lingam TMC, Tan KY, Tan CH. Proteomics and antivenom immunoprofiling of Russell’s viper (Daboia siamensis) venoms from Thailand and Indonesia. J Venom Anim Toxins Incl Trop Dis. 2020;26. doi: 10.1590/1678-9199-JVATITD-2019-0048

Waiddyanatha S, Silva A, Siribaddana S, Isbister GK. Long-term effects of snake envenoming. Toxins (Basel). 2019;11(4):193. doi: 10.3390/toxins11040193.

Kumar M, Arcot Thanjan M, Gopalakrishnan N, Jeyachandran D, Thanigachalam D, Ramanathan S. Snake envenomation-induced acute kidney injury: prognosis and long-term renal outcomes. Postgrad Med J. 2022;98(1158):264–8. doi: 10.1136/postgradmedj-2020-139021

Gopalakrishnan N. Snake envenoming—an underreported cause of acute kidney injury. Kidney Int Rep. 2019;4(5):643–6. doi: 10.1016/j.ekir.2019.03.014

Vikrant S, Jaryal A, Parashar A. Clinicopathological spectrum of snake bite-induced acute kidney injury from India. World J Nephrol. 2017;6(3):150–61. doi: 10.5527/wjn.v6.i3.150

Ariga K, Dutta TK, Haridasan S, Pillai Puthenpurackal PS, Harichandrakumar KT, Parameswaran S. Chronic kidney disease after snake envenomation induced acute kidney injury. Saudi J Kidney Dis Transpl. 2021;32(1):146–56. doi: 10.4103/1319-2442.318516

Sarkar S, Sinha R, Chaudhury AR, Maduwage K, Abeyagunawardena A, Bose N, et al. Snake bite associated with acute kidney injury. Pediatr Nephrol. 2021;36(12):3829–40. doi: 10.1007/s00467-020-04911-x

Kementerian Kesehatan RI. Buku pedoman penanganan gigitan, sengatan hewan berbisa dan keracunan tumbuhan dan jamur. Jakarta: Kementerian Kesehatan RI; 2023.

Moon J, Chun B, Cho Y, Park K. Clinical characteristics of snake envenomation-related acute kidney injury in South Korea. Sci Rep. 2024;14:23503. doi: 10.1038/s41598-024-74142-9

Rao IR, Prabhu AR, Nagaraju SP, Rangaswamy D. Thrombotic microangiopathy: an under-recognised cause of snake-bite-related acute kidney injury. Indian J Nephrol. 2019;29(5):324–8. doi: 10.4103/ijn.IJN_280_18

Jayawardana S, Arambepola C, Chang T, Gnanathasan A. Long-term health complications following snake envenoming. J Multidiscip Healthc. 2018;11:279–85. doi: 10.2147/JMDH.S126648

Kunti R, Muralikrishna K, Sunitha B, Prakash DB. Acute kidney injury in snake bite patients: a prospective observational study in a tertiary care hospital Telangana India. Int J Health Sci. 2022;6(Suppl 8):1977–85. doi: 10.53730/ijhs.v6nS8.12534

Downloads

Published

2026-06-30

Issue

Section

Case Report

How to Cite

Venomous Aftermath: A Case of Chronic Kidney Disease Following a Snake Bite. (2026). International Journal of Integrated Health Sciences, 14(1), 76-82. https://doi.org/10.15850/ijihs.v14n1.4579