Clinical and Molecular Hepatology (대한간학회지)

The Korean Association for the Study of the Liver (대한간학회)
권호 표지

Clinical Features of Acute Viral Hepatitis A Complicated with Acute Renal Failure

급성 신기능상실이 합병된 급성 A형간염의 임상상

Song, Kee-Sup;Kim, Min-Ju;Jang, Chang-Soo;Jung, Hyuk-Sang;Lee, Hyun-Hee;Kwon, Oh-Sang;Kim, Yun-Soo;Choi, Duck-Joo;Kim, Ju-Hyun;Ha, Seung-Yeon
송기섭;김민주;장창수;정혁상;이현희;권오상;김연수;최덕주;김주현;하승연

  • Published : 2007.06.25
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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

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