Clinical characteristics of acute hepatitis A complicated by acute kidney injury

Abstract

Background: The incidence of acute viral hepatitis A (AHA) in Korea is increasing rapidly. Additionally, we are encountering more cases with acute kidney injury (AKI), which was once regarded as a rare complication of AHA. Thus, we investigated recent aspects of the incidence and clinical characteristics of AHA complicated by AKI. Methods: Patients diagnosed with AHA at 2 referral hospitals in Seoul during the period January 2006 to December 2009 were enrolled. Results: Of 1025 patients, 71 (6.9%) had AKI. The incidence of AKI was 3.1% in 2006, 6.0% in 2007, 8.9% in 2008, and 6.9% in 2009. Patients with AKI were predominantly male, heavy alcohol drinkers, and smokers, and also had a higher rate of underlying hypertension than patients without AKI. At admission, patients with AKI had significantly higher white blood cell counts, prolonged prothrombin times, and elevated liver enzymes, including total and direct bilirubin, gamma-glutamyltransferase, and C-reactive protein. Additionally, patients with AKI had a higher peak total bilirubin level and lower initial serum albumin level than patients without AKI. Conclusion: Although most patients with AHA complicated by AKI recover with conservative treatment, we should pay particular attention to patients who have risk factors for AKI.

Keywords::

• Acute hepatitis A
• acute kidney injury
• risk factor

Acknowledgements

Special thanks to N. R. Chon, of the Medical Department at Gangnam Severance Hospital, for his advice on the statistics and methodology. This work was presented at the Seoul International Liver Symposium in Seoul, Korea, September 2009.

Declaration of interest: There are no competing financial interests to declare. The authors alone are responsible for the contents and writing of the paper.