Korean J Hepatol.  2007 Jun;13(2):166-173.

Clinical Features of Acute Viral Hepatitis A Complicated with Acute Renal Failure

• Song KS
• Kim MJ
• Jang CS
• Jung HS
• Lee HH
• Kwon OS
• Kim YS
• Choi DJ
• Kim JH
• Ha SY

Abstract

BACKGROUND: Most patients with acute viral hepatitis A (AVHA) spontaneously recover, but a few patients experience complications. This study was carried out to examine clinical features of AVHA complicated with acute renal failure (ARF). METHOD: Medical records of 404 patients with AVHA were reviewed. Clinical features of AVHA patients with ARF (group A) were compared with those of AVHA patients without ARF (group B). RESULT: ARF complication was present in 11 patients (3%). There were no differences between group A and B in sex ratio and age. Microscopic hematuria (7 cases), proteinuria (7 cases), metabolic acidosis (4 cases), oliguria (4 cases), pulmonary edema (3 cases) and hyperkalemia (2 cases) were found in group A. The prevalence of heavy alcohol drinking (64% vs 3%, p<0.001) and diabetes mellitus (18% vs 1%, p=0.01) was higher in group A than B. The peak value of ALT (median: 4,290 IU/L vs 1,266 IU/L, p=0.006) and total bilirubin (median: 10.8 mg/dL vs 6.0 mg/dL, p=0.001) was higher in group A than B. Duration of admission was longer in group A than B (median: 14 days vs 5 days, p<0.001). Four patients of group A recovered with renal replacement therapy, while 7 patients recovered with conservative treatment. CONCLUSIONS: The AVHA patients with ARF experienced more severe hepatitis than those without ARF, but they had a good prognosis with the proper treatment.

Keyword

Hepatitis A; Kidney failure; Outcome assessment, patient; Complications

MeSH Terms

Acute Disease
Adolescent
Adult
Aged
Aged, 80 and over
Alanine Transaminase/analysis
Bilirubin/analysis
Biological Markers/blood
Child
Diabetes Mellitus/epidemiology
Female
Hepatitis A/*complications/diagnosis
Humans
Kidney Failure, Acute/*virology
Male
Middle Aged
Prevalence
Prognosis
Retrospective Studies