[Clinical features of acute viral hepatitis A complicated with acute renal failure].
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).


METHODS
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).


RESULTS
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.
Song
Kee Sup
KS
Department of Internal Medicine, Gachon Medical College, Inchon, Korea.
Kim
Min Ju
MJ
Jang
Chang Soo
CS
Jung
Hyuk Sang
HS
Lee
Hyun Hee
HH
Kwon
Oh Sang
OS
Kim
Yun Soo
YS
Choi
Duck Joo
DJ
Kim
Ju Hyun
JH
Ha
Seung Yeon
SY
D000208:Acute Disease; D058186:Acute Kidney Injury / Q000821:virology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000410:Alanine Transaminase / Q000032:analysis; D001663:Bilirubin / Q000032:analysis; D015415:Biomarkers / Q000097:blood; D002648:Child; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006506:Hepatitis A / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D012189:Retrospective Studies
D015415:Biomarkers; D000410:Alanine Transaminase; D001663:Bilirubin