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Lawan Chanhome, Visith Sitprija and Narongsak Chaiyabutr

Abstract

Background: Many studies have reported the occurrence of lethal acute renal failure after snakebites. Bungarus candidus (Malayan krait) is a medically important venomous snake distributed widely throughout Southeast Asia. The best known features of systemic envenoming by B. candidus are neurotoxic. Objective: Obtain more information on effects of B. candidus venom on changes in systemic and renal hemodynamics in experimental animals. Methods: Twelve adult male New Zealand white rabbits were used to study the effect of B. candidus venom on general circulation and renal hemodynamics. An anesthetized animal was intravenously injected with B. candidus venom at a dosage of 50μg/kg bodyweight. All changes of parameters were observed after initial post venom injection and recorded at 30 min intervals until 150 minutes after envenomation. Results: After envenomation, cardiovascular responses showed a marked decrease in mean arterial pressure within two minutes, afterwards gradually returning closely to baseline values. There were stepwise decreases in heart rate and cardiac output, while total peripheral resistance was slightly increased. The renal hemodynamics significantly decreased by glomerular filtration rate, effective renal plasma flow and effective renal blood flow, while the filtration fraction significantly increased. Envenomed animals showed a reduction in renal fraction, while renal vascular resistance stepwise increased. The plasma potassium level tended to increase. Animals showed stepwise decreases in urinary excretion of Na+, K+ and Cl-. A marked decrease in plasma calcium level was apparent at 120 minutes, while plasma creatine phosphokinase and lactate dehydrogenase levels increased at 30-120 minutes. Conclusion: A significant drop in blood pressure was attributed to a sustained fall in cardiac output, which would be associated with a reduction in heart rate. Sustained hypotension would contribute to reduction of renal blood flow, which results in decreased GFR.

Open access

Narongsak Chaiyabutr, Taksa Vasaruchapong, Lawan Chanhome, Anudep Rungsipipat and Visith Sitprija

Abstract

Background: The common complication in cases of poisoning by Russell’s viper (Daboia siamensis) venom (RVV) is acute renal failure, but the pathogenesis involved in the alteration of kidney function is still not well understood.

Objective: To clarify the role of RVV in the pathogenesis of renal damage, the present study examines the functional short-term alterations acutely induced by RVV in isolated perfused rabbit kidney.

Methods: Effects of RVV on renal tubular handling of sodium including mean perfusion pressure (PP), the renalvascular resistance (RVR), the glomerular filtration rate (GFR), the urinary flow (V) and osmolar clearance (Cosm) were studied in two groups of isolated perfused rabbit kidneys; each group had four isolated rabbit kidneys. RVV was added to the perfusion system to obtain the final concentration of 10 ⃞g/ml.

Results: Immediate decreases in PP and RVR caused by the venom were significantly apparent (p < 0.05) in the first 15 min after RVV administration. A gradual rise in both PP and RVR occurred 15 min after the initial reduction of the first phase, but its remained below pretreatment values. The GFR, V, and Cosm decreased significantly throughout experiments after venom perfusion (p < 0.05). The total fractional sodium excretion increased significantly after venom perfusion throughout experiments, while significant reductions (p < 0.05) of renal tubular handling of sodium were apparent for proximal absolute reabsorption of sodium and proximal fractional reabsorption of sodium including marked reductions of distal absolute reabsorption of sodium and distal fractional reabsorption of sodium of the venom treated kidney. Optical microscopy of treated kidney tissue showed acute tubular necrosis at the end of experiment.

Conclusion: The present study suggests that an administration of RVV in the isolated rabbit kidney causes direct acute nephrotoxicity and acute alterations of main functional parameters that are probably mediated by either the direct action of venom components or an indirect effect from vasoactive mediators released from renal cells of the RVV-treated kidney.

Open access

Lawan Chanhome, Merel Jack Cox, Taksa Vasaruchapong, Narongsak Chaiyabutr and Visith Sitprija

Abstract

Background: Envenoming by snakebite is an important public health problem in rural tropics. Venomous snake families such as Elapidae and Viperidae frequently produce severe poisoning. Anti-venoms are not available for all venomous snakes of Thailand and there is need for more development in this field.

Objective: We characterized the important venomous snakes’ distribution of Thailand.

Method:Venomous snake species are described in details including their identification, range, and extraterritorial distribution.

Result: Eighteen snake species of the family Elapidae are summarized in their characteristics and distribution. There are three species of Naja, one species of Ophiophagus, three species of Bungarus, four species of Calliophis, one species of Sinomicrurus, two species of Laticauda, and four species of subfamily Hydrophiinae. Fifteen snake species of the family Viperidae consisting of one species of subfamily Viperinae and fourteen species of subfamily Crotalinae are also discussed.

Conclusion: All these snakes are venomous and their venom is potentially fatal since birth.