Serum and urinary biomarkers for early detection of acute kidney injury following Hypnale spp. envenoming.
Background Hump-nosed pit viper (HNV; Hypnale spp.) bites account for most venomous snakebites in Sri Lanka. Acute kidney injury (AKI) is the most serious systemic manifestation (1-10%) following HNV envenoming. We aimed to identify the value of functional and injury biomarkers in predicting the dev...
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ftdoajarticles:oai:doaj.org/article:f3c73dd72db34b07bea84fc50ad7b920 2023-05-15T15:17:43+02:00 Serum and urinary biomarkers for early detection of acute kidney injury following Hypnale spp. envenoming. Eranga Sanjeewa Wijewickrama Fahim Mohamed Indika B Gawarammana Zoltan H Endre Nicholas A Buckley Geoffrey K Isbister 2021-12-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0010011 https://doaj.org/article/f3c73dd72db34b07bea84fc50ad7b920 EN eng Public Library of Science (PLoS) https://doi.org/10.1371/journal.pntd.0010011 https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0010011 https://doaj.org/article/f3c73dd72db34b07bea84fc50ad7b920 PLoS Neglected Tropical Diseases, Vol 15, Iss 12, p e0010011 (2021) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2021 ftdoajarticles https://doi.org/10.1371/journal.pntd.0010011 2022-12-31T11:06:33Z Background Hump-nosed pit viper (HNV; Hypnale spp.) bites account for most venomous snakebites in Sri Lanka. Acute kidney injury (AKI) is the most serious systemic manifestation (1-10%) following HNV envenoming. We aimed to identify the value of functional and injury biomarkers in predicting the development of AKI early following HNV bites. Methods We conducted a prospective cohort study of patients with confirmed HNV envenoming presenting to two large tertiary care hospitals in Sri Lanka. Demographics, bite details, clinical effects, complications and treatment data were collected prospectively. Blood and urine samples were collected from patients for coagulation and renal biomarker assays on admission, at 0-4h, 4-8h, 8-16h and 16-24h post-bite and daily until discharge. Follow-up samples were obtained 1 and 3 months post-discharge. Creatinine (sCr) and Cystatin C (sCysC) were measured in serum and kidney injury molecule-1 (uKIM-1), clusterin (uClu), albumin (uAlb), β2-microglobulin (uβ2M), cystatin C (uCysC), neutrophil gelatinase associated lipocalin (uNGAL), osteopontin (uOPN) and trefoil factor-3 (uTFF-3) were measured in urine. Definite HNV bites were based on serum venom specific enzyme immunoassay. Kidney Disease: Improving Global Outcomes (KDIGO) criteria were used to stage AKI. Two patients had chronic kidney disease at 3 month follow-up, both with pre-existing abnormal sCr, and one developed AKI following HNV envenoming. Results There were 52 patients with confirmed HNV envenoming; median age 48y (Interquartile range [IQR]:40-59y) and 29 (56%) were male. Median time to admission was 1.87h (IQR:1-2.75h). Twelve patients (23%) developed AKI (AKI stage 1 = 7, AKI stage 2 = 1, AKI stage 3 = 4). Levels of five novel biomarkers, the functional marker serum Cystatin C and the damage markers urinary NGAL, cystatin C, β2-microglobulin and clusterin, were elevated in patients who developed moderate/severe acute kidney injury. sCysC performed the best at 0-4 h post-bite in predicting moderate to severe AKI ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLOS Neglected Tropical Diseases 15 12 e0010011 |
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Directory of Open Access Journals: DOAJ Articles |
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English |
topic |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Eranga Sanjeewa Wijewickrama Fahim Mohamed Indika B Gawarammana Zoltan H Endre Nicholas A Buckley Geoffrey K Isbister Serum and urinary biomarkers for early detection of acute kidney injury following Hypnale spp. envenoming. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
Background Hump-nosed pit viper (HNV; Hypnale spp.) bites account for most venomous snakebites in Sri Lanka. Acute kidney injury (AKI) is the most serious systemic manifestation (1-10%) following HNV envenoming. We aimed to identify the value of functional and injury biomarkers in predicting the development of AKI early following HNV bites. Methods We conducted a prospective cohort study of patients with confirmed HNV envenoming presenting to two large tertiary care hospitals in Sri Lanka. Demographics, bite details, clinical effects, complications and treatment data were collected prospectively. Blood and urine samples were collected from patients for coagulation and renal biomarker assays on admission, at 0-4h, 4-8h, 8-16h and 16-24h post-bite and daily until discharge. Follow-up samples were obtained 1 and 3 months post-discharge. Creatinine (sCr) and Cystatin C (sCysC) were measured in serum and kidney injury molecule-1 (uKIM-1), clusterin (uClu), albumin (uAlb), β2-microglobulin (uβ2M), cystatin C (uCysC), neutrophil gelatinase associated lipocalin (uNGAL), osteopontin (uOPN) and trefoil factor-3 (uTFF-3) were measured in urine. Definite HNV bites were based on serum venom specific enzyme immunoassay. Kidney Disease: Improving Global Outcomes (KDIGO) criteria were used to stage AKI. Two patients had chronic kidney disease at 3 month follow-up, both with pre-existing abnormal sCr, and one developed AKI following HNV envenoming. Results There were 52 patients with confirmed HNV envenoming; median age 48y (Interquartile range [IQR]:40-59y) and 29 (56%) were male. Median time to admission was 1.87h (IQR:1-2.75h). Twelve patients (23%) developed AKI (AKI stage 1 = 7, AKI stage 2 = 1, AKI stage 3 = 4). Levels of five novel biomarkers, the functional marker serum Cystatin C and the damage markers urinary NGAL, cystatin C, β2-microglobulin and clusterin, were elevated in patients who developed moderate/severe acute kidney injury. sCysC performed the best at 0-4 h post-bite in predicting moderate to severe AKI ... |
format |
Article in Journal/Newspaper |
author |
Eranga Sanjeewa Wijewickrama Fahim Mohamed Indika B Gawarammana Zoltan H Endre Nicholas A Buckley Geoffrey K Isbister |
author_facet |
Eranga Sanjeewa Wijewickrama Fahim Mohamed Indika B Gawarammana Zoltan H Endre Nicholas A Buckley Geoffrey K Isbister |
author_sort |
Eranga Sanjeewa Wijewickrama |
title |
Serum and urinary biomarkers for early detection of acute kidney injury following Hypnale spp. envenoming. |
title_short |
Serum and urinary biomarkers for early detection of acute kidney injury following Hypnale spp. envenoming. |
title_full |
Serum and urinary biomarkers for early detection of acute kidney injury following Hypnale spp. envenoming. |
title_fullStr |
Serum and urinary biomarkers for early detection of acute kidney injury following Hypnale spp. envenoming. |
title_full_unstemmed |
Serum and urinary biomarkers for early detection of acute kidney injury following Hypnale spp. envenoming. |
title_sort |
serum and urinary biomarkers for early detection of acute kidney injury following hypnale spp. envenoming. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2021 |
url |
https://doi.org/10.1371/journal.pntd.0010011 https://doaj.org/article/f3c73dd72db34b07bea84fc50ad7b920 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 15, Iss 12, p e0010011 (2021) |
op_relation |
https://doi.org/10.1371/journal.pntd.0010011 https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0010011 https://doaj.org/article/f3c73dd72db34b07bea84fc50ad7b920 |
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https://doi.org/10.1371/journal.pntd.0010011 |
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PLOS Neglected Tropical Diseases |
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15 |
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12 |
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e0010011 |
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