Acute hepatitis A-associated acute renal failure in adults.
OBJECTIVE
The development of acute renal failure (ARF) is a very rare complication in patients with acute hepatitis A (AHA).


METHODS
We retrospectively investigated the overall incidence, risk factors, and clinical outcomes of ARF associated with AHA. Diagnosis of AHA was made according to the typical hepatitis symptoms and positivity of immunoglobulin M anti-hepatitis A virus in 208 patients with AHA.


RESULTS
ARF was noted in 12 (5.7%) patients, and dialysis was required in 8 (66%) patients. The median duration of hospitalization for patients with ARF was 18 days (range, 6-50 days). The development of ARF was observed in older patients (p = 0.004) and in patients with diabetes (p = 0.001), excessive alcohol consumption (p = 0.01), prolonged international normalized ratio (p = 0.019), and elevated aspartate aminotransferase concentration (p = 0.034). Multivariate analysis revealed that old age (odds ratio, OR, 1.2), elevated aspartate aminotransferase concentration (OR, 1.05), and diabetes (OR, 18.5) were independent risk factors for ARF (each p < 0.001). The prognosis of patients with ARF was good, and renal function recovered completely.


CONCLUSIONS
ARF associated with AHA is not rare, and the possibility of AHA should be considered in patients with ARF with hepatic dysfunction.
Kim
Su Hyun
SH
Department of Internal Medicine, College of Medicine, Chung-Ang University, Seoul, South Korea.
Yoon
Hye Eun
HE
Kim
Yong Kyun
YK
Kim
Jin Young
JY
Choi
Bum Soon
BS
Choi
Young Jin
YJ
Kim
Young Ok
YO
Kim
Yong Soo
YS
Bang
Byung Kee
BK
Yang
Chul Woo
CW
D000208:Acute Disease; D058186:Acute Kidney Injury / Q000453:epidemiology* / Q000503:physiopathology / Q000628:therapy; D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D006506:Hepatitis A / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D006801:Humans; D015994:Incidence; D007723:Korea / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D012189:Retrospective Studies; D012307:Risk Factors