Acute renal tubular injury with acute hepatitis A infection: is it just a coincidence?
Acute renal failure has rarely been reported in association with acute hepatitis A infection. The commonest form of renal injury in such patients has been found to be acute tubular necrosis. We report two cases of hepatitis A infection in which acute renal failure occurred very early in the course of the illness and had a clinical presentation and recovery pattern suggestive of acute tubular necrosis. In both patients, the clinical course of renal dysfunction was almost parallel to the course of hepatic dysfunction. Patient 1 needed dialysis, whereas patient 2 did not need dialysis and had a very rapid recovery from renal function in spite of having more severe azotaemia. Patient 2 was administered acetylcysteine in high doses for suspected fulminant hepatic failure. A potential benefit of a high dose of acetylcysteine in recovery of renal function from acute tubular necrosis is postulated.
Department of Nephrology, PD Hinduja National Hospital and Medical Research Centre, Mahim, Mumbai, India.
Gautam R
GR
Shroff
SunilL V
SV
Badve
Anand G
AG
Joshi
Devendra C
DC
Desai
Philip
P
Abraham
Rasika A
RA
Sirsat
D000208:Acute Disease; D058186:Acute Kidney Injury / Q000150:complications*; D000328:Adult; D005260:Female; D006506:Hepatitis A / Q000150:complications*; D006801:Humans; D008297:Male