A STUDY TO DETERMINE IF HEMATURIA IN PATIENTS WITH SNAKE BITE CAN BE USED AS A CRITERIA FOR FORCED ALKALINE DIURESISTO PREVENT AKI

Hematuria and Acute kidney injury (AKI) are important causes of morbidity and mortality among victims of snake bite. As per Ministry of Health & Family Welfare Government of India, if the patient has oliguria or dipstick positive for blood give a trial of forced alkaline diuresis (FAD) within first 24 hours of the bite to avoid pigment nephropathy leading to acute tubular necrosis (ATN)¹⁹. In the current study we aim to determine if hematuria can be used as criteria for Forced Alkaline Diuresis in patient who present with hematuria following snake bite who later develop AKI. Results depicted that majority of the study subjects i.e., 88% AKI was not observed. However, urine output in study subjects at 6 hours was not significantly differed with the urine output of study subjects at 12 hours (χ² = 0.219) and at 24 hours (χ² = 0.066). Microscopic RBCs were present in 40%, 28%, and 24% of study subjects urine sample at 6 hours,12 hours, and 24 hours respectively. Furthermore, presence of microscopic RBCs in urine samples of study subjects at 6 hours significantly differed with the microscopic RBCs in urine samples of study subjects at 12 hours (χ² = 0.000) and at 24 hours (χ² = 0.001). In conclusion, patient with snake bite with presence of hematuria do not have AKI as a complication & hence hematuria cannot be used as criteria for Forced Alkaline Diuresis for the treatment of AKI in snake bite.