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Korean J Hepatol > Volume 13(2); 2007 > Article
The Korean Journal of Hepatology 2007;13(2): 166-173.
Clinical Features of Acute Viral Hepatitis A Complicated with Acute Renal Failure
Kee Sup Song, M.D., Min Ju Kim, M.D., Chang Soo Jang, M.D., Hyuk Sang Jung, M.D., Hyun Hee Lee, M.D., Oh Sang Kwon, M.D., Yun Soo Kim, M.D., Duck Joo Choi, M.D., Ju Hyun Kim, M.D., Seung Yeon Ha, M.D.1
Department of Internal Medicine and Pathology1, Gachon Medical College, Inchon, Korea
Abstract
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).
Method:
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). Result: 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. (Korean J Hepatol 2007;13:166-173)
KeyWords: Hepatitis A; Kidney failure; Outcome assessment, patient; Complications
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