Renal Complications and Snakebite Accidents Caused by Vipers of the Bothrops Genus: A Systematic Review

Introduction: Renal complications following snakebites remain poorly understood due to insufficient evidence. Observational studies have limitations in determining precise frequency. In Brazil, acute kidney injury (AKI) occurs in 8-43% of envenomed patients, with 15% requiring renal replacement therapy and mortality rates ranging from 8-39%. In Colombia, the incidence remains undetermined; however, a study conducted in Medellín reported a 38.5% incidence of AKI with significant clinical impact. Objectives: To compile existing literature regarding acute renal complications in the context of Bothrops snakebite envenomation. Methods: A systematic review was conducted following PRISMA guidelines, implementing 12 search strategies across five databases. Thoroughness, reproducibility, and methodological quality were ensured. Results: The frequency of acute kidney injury in patients with Bothrops snakebite envenomation ranged from 0.6% to 12.8%. Conclusions: Envenomation severity and infection are not directly associated with an increased risk of renal complications in Bothrops snakebite accidents. Advanced age, hemorrhagic manifestations, and elevated lactate dehydrogenase levels were identified as potentially associated factors.