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

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.