Clinical Features of Acute Hepatitis A-related Acute Kidney Injury

초록

Introduction: The purpose of this study was to analyze the clinical features of acute renal injury (AKI) in adults with AHA. Methods: Clinical and laboratory data of patients with AHA from January 2005 to December 2009 were reviewed. We retrospectively investigated the overall incidence, clinical features of AKI-AHA in our hospital. Results: Total 1231 patients with AHA were admitted during 5 years and the incidence of AHA was dramatically increased since 2008. AKI was noted in 40 cases in those AHA patients (3.24%). Among these patients, dialysis was required in 8 cases (20.0%). Mean ages of AKI patients were in the middle of 4th decade, male was 33 (82.5%). Baseline BUN, creatinine, liver enzymes AST, ALT, total bilirubin and prothrombin time (INR) were silmutaneously elevated. Serum creatinine levels were peak (6.3 ± 5.7 mg/dl) at 3rd hospital day. Serum AST, ALT and total bilirubin were 2353 ± 2547 IU/l, 2887 ± 2052 IU/I, and 9.3 ± 5.4 mg/dl respectively at that time. The serum creatinine (11.4 ± 5.5 vs 3.1 ± 1.8 and total bilirubin (8.7 ± 4.6 vs 4.5 ± 2.1 mg/dl) were signifi cantly higher in patients on dialysis group than non-dialysis group. Mean 4.3 ± 2.3 sessions of HD were performed and renal function was completely recovered in all patients. Conclusion: In our study of AHA, AKI is not rare in clinical course of hepatitis A. Recovery of renal function and mortality were determined by the presence of liver dysfunction. AKI with AHA is associated with good prognosis.