title: Acute hepatitis A-associated acute renal failure in adults.
abstract: 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.
authors.affiliation: Department of Internal Medicine, College of Medicine, Chung-Ang University, Seoul, South Korea.
authors.forename: Su Hyun
authors.initials: SH
authors.lastname: Kim
authors.forename: Hye Eun
authors.initials: HE
authors.lastname: Yoon
authors.forename: Yong Kyun
authors.initials: YK
authors.lastname: Kim
authors.forename: Jin Young
authors.initials: JY
authors.lastname: Kim
authors.forename: Bum Soon
authors.initials: BS
authors.lastname: Choi
authors.forename: Young Jin
authors.initials: YJ
authors.lastname: Choi
authors.forename: Young Ok
authors.initials: YO
authors.lastname: Kim
authors.forename: Yong Soo
authors.initials: YS
authors.lastname: Kim
authors.forename: Byung Kee
authors.initials: BK
authors.lastname: Bang
authors.forename: Chul Woo
authors.initials: CW
authors.lastname: Yang
mesh_terms: 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