obliqua envenomation, the mechanisms involved in kidney disorders are poorly understood ( Gamborgi et al., 2006). The current knowledge is based on clinical data from human victims in which hematuria, high levels of serum check details creatinine and acute tubular necrosis were described to be the main features of L. obliqua-induced AKI ( Burdmann et al., 1996). In our experimental model, in addition to the high levels of serum creatinine, the rats also displayed uremia and hyperuricemia, suggesting impaired renal function. Generally, the mechanism underlying venom-induced AKI is complex and appears to be multifactorial. Until now, studies performed with a variety of nephrotoxic

venoms have indicated that AKI is associated with both the direct cytotoxic action of the venom on renal structures and a secondary response of the whole organism resulting from systemic envenomation ( Abdulkader et al., 2008 and Berger et al., 2012). The secondary response is usually triggered by renal inflammation, oxidative damage and

the release of cytokines and vasoactive substances that lead to changes in renal function and hemodynamics. Hemolysis, rhabdomyolysis and/or the intravascular deposition of platelets and fibrin in the kidney microcirculation are also important contributors to this process ( Sitprija, 2006). Recently, high levels of uric acid were observed to play an important role in AKI induced by Crotalus envenomation, since the treatment with

allopurinol, a hypouricemiant agent, significantly reduced the lethality rate and ameliorated renal histopathological changes 5-FU order ( Frezzatti and Silveira, 2011). Marked hyperuricemia is known to cause AKI by the supersaturation, crystallization and deposition of urate crystals, as well as by contributing to renal vasoconstriction, since soluble uric acid has been shown to inhibit endothelial NO bioavailability ( Yamasaki et al., 2008 and Ejaz et al., 2007). During L. obliqua envenomation, the rats also presented high levels of uric acid, tubular obstructive casts and inflammatory infiltrates in the kidneys. However, the actual contribution of these elements to AKI requires further study. Interestingly, antivenom serotherapy was able to reduce creatinine and urea levels only if administered within 2 h of LOBE injection. Antivenom treatment after 6 h was unable to fully Baricitinib correct the renal parameters, despite its ability to normalize coagulation abnormalities. Thus, it seems that the time elapsed between the accident and the administration of antivenom is crucial for a successful renal therapy. Confirming our observations, it was demonstrated that a time interval of more than 2 h between the accident and administration of the antivenom was associated with the development of AKI, as well as with the risk of death or permanent injuries after Bothrops and Crotalus envenomation ( Otero et al., 2002 and Pinho et al., 2005).