The characteristics of acute kidney injury complicated in acute hepatitis A

Abstract

Contrary to our expectations, acute kidney injury (AKI) is not an unusual complication in patients with acute hepatitis A (AHA). The objective of this study was to describe the clinical characteristics and risk factors for AKI in adults with AHA. Ninety-eight patients were enrolled between 2005 and 2008. There were no significant differences in clinical features and demographic characteristics. A reduction in haematocrit and platelets, and prolongation of the international normalized ratio (INR) were observed in AHA patients with AKI (p<0.05). The mean duration of hospitalization was longer in AKI-complicated patients (p<0.05). AKI developed in 6 of 98 patients with AHA, and the median peak value of serum creatinine was 508.3 µmol/l. All of the patients recovered completely without dialysis therapy. By multivariate analysis, a lower platelet count (relative risk (RR) 14.71; p=0.036), the presence of coagulopathy (RR 18.87; p=0.048), and an elevated AST (RR 9.11; p=0.043) or ALT (RR20; p=0.01) on admission were independent risk factors for AKI in patients with AHA. In conclusion, more attention should be paid to whether AKI develops in patients with AHA, especially in patients with risk factors, and strategies to prevent AHA in adults should be considered carefully.