Amaral C F, Da Silva O A, Goody P, Miranda D
Toxicon. 1985;23(6):877-85. doi: 10.1016/0041-0101(85)90379-4.
Out of 22 patients admitted to the Intensive Care Unit of the Hospital das Clínicas, Federal University of Minas Gerais, with acute renal failure following Bothrops snake bite, 7 had renal cortical necrosis. This complication was suspected when the oligoanuric phase ranged from 21 to 28 days or when the patient, in spite of having a polyuric phase, maintained elevated blood levels of urea and creatinine after the interruption of the dialysis program, and was confirmed by a kidney biopsy. Three patients died and in two of them renal cortical necrosis was found at necropsy. Four patients were discharged from the hospital and follow-up was possible in two of them who showed recovery of renal function. Vasospasm, direct nephrotoxicity of Bothrops venom and/or disseminated intravascular coagulation leading to vascular occlusion and renal ischemia are the proposed pathogenetic mechanisms to explain renal cortical necrosis following Bothrops snake bite.
在米纳斯吉拉斯联邦大学临床医院重症监护病房收治的22例因被矛头蝮蛇咬伤而发生急性肾衰竭的患者中，7例出现肾皮质坏死。当少尿期持续21至28天，或者患者尽管进入多尿期，但在透析程序中断后血尿素和肌酐水平仍持续升高时，怀疑出现了这种并发症，通过肾活检得以确诊。3例患者死亡，其中2例在尸检时发现肾皮质坏死。4例患者出院，其中2例患者肾功能恢复且得以随访。血管痉挛、矛头蝮蛇毒液的直接肾毒性和/或弥散性血管内凝血导致血管闭塞和肾缺血是解释矛头蝮蛇咬伤后肾皮质坏死的推测发病机制。
