Recent changes and clinical characteristics of acute hepatitis A complicated by acute kidney injury

Abstract

The incidence of acute viral hepatitis A (AHA) in Korea is increasing quickly. In addition, we are encountering more cases with acute kidney injury (AKI), which was once regarded as a rare complication of AHA. Therefore, we investigated recent aspects of the incidence and clinical characteristics of AHA complicated by AKI. Patients diagnosed with acute hepatitis A at Severance Hospital and Gangnam Severance Hospital from January 2006 to December 2009 were enrolled. Of 1025 patients, 71 (6.9%) had AKI. The incidence of AKI was 3.1%, 6.0%, 8.9%, and 6.9% in 2006 to 2009, respectively. Patients with AKI were predominantly male, heavy alcohol drinkers and smokers and had more underlying hypertension than patients without AKI. The patients with AKI had significantly higher white blood cell counts, more prolonged prothrombin times, and elevated liver enzymes, total bilirubin, direct bilirubin, gamma-glutamyltransferase, C-reactive protein, and higher peak of total bilirubin levels, whereas the serum albumin level was lower compared to patients without AKI. Most patients with AHA complicated by AKI recover with conservative treatment, however, we should pay attention to the patients who have risk factors for AKI because of their possible poor clinical course.