Acute renal failure and coagulopathy after snakebite

A non-fatal case of acute renal failure with associated coagulopathy after envenomation by a western brown snake (Pseudonaja nuchalis) is described. The coagulopathy did not respond to the initial administration of polyvalent antivenom, but resolved rapidly after later infusion of large doses of specific antivenom. The renal failure necessitated haemodialysis for 12 days and then resolved completely. There were no signs of neurotoxic envenomation. Other Australian cases of snakebite associated with renal failure or coagulopathy are reviewed. An adequate dose of the correct antivenom, and infusion of fresh frozen plasma if indicated, is the best treatment of coagulopathy after snakebite.