Clinical Features and Predictive Factors of Acute Hepatitis A Complicated with Acute Kidney Injury.
10.4166/kjg.2010.56.6.359
- Author:
Jin Hee LEE
1
;
Moon Seok CHOI
;
Geum Yeon GWAK
;
Joon Hyoek LEE
;
Kwang Cheol KOH
;
Seung Woon PAIK
;
Byung Chul YOO
Author Information
1. Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. drmschoi@gmail.com
- Publication Type:Original Article ; English Abstract
- Keywords:
Acute kidney injury;
Hepatitis A;
Survival;
Transplantation
- MeSH:
Acute Disease;
Acute Kidney Injury/complications/*diagnosis/therapy;
Adult;
Age Factors;
Alanine Transaminase/blood;
Aspartate Aminotransferases/blood;
Bilirubin/blood;
Creatine/blood;
Female;
Hemoglobins/analysis;
Hepatitis A/complications/*diagnosis;
Humans;
Hypoalbuminemia/complications;
Liver Transplantation;
Male;
Middle Aged;
Odds Ratio;
Platelet Count;
Predictive Value of Tests;
Prognosis;
Prothrombin Time;
Serum Albumin/analysis;
Thrombocytopenia/complications
- From:The Korean Journal of Gastroenterology
2010;56(6):359-364
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND/AIMS: We assessed the clinical features and prognosis of acute viral hepatitis A (AHA) complicated with acute kidney injury (AKI) and elucidated predictive factors for AKI in patients with AHA. METHODS: We reviewed medical record of 391 patients with AHA admitted at our institution since 2000. RESULTS: AKI was present in 45 patients (11.5%). The proportion of the AKI group increased since 2008 (5.4% before 2008 vs. 15.9% since 2008, p=0.001). The AKI group was older than the non-AKI group (35.7+/-8.7 years vs. 31.3+/-7.8 years, p=0.002). Other baseline clinical characteristics were similar between two groups. Initial hemoglobin, platelet, and serum albumin were significantly low and prothrombin time, serum bilirubin, creatinine, AST, and ALT were significantly high in the AKI group. Hepatic encephalopathy, ascites, gastrointestinal bleeding, and sepsis were more frequently observed in the AKI group. While six patients (13%) in the AKI group received liver transplantation (LT) but three patients died within one month, one patient in the non-AKI group receiving LT is alive. Multivariate analysis showed that older age (OR 1.07, 95% CI 1.02-1.12), initial thrombocytopenia <150,000/mm2 (OR 2.85, 95% CI 1.24-6.57), prothrombin time (PT) prolongation (OR 5.34, 95% CI 2.55-11.19), and hypoalbuminemia (OR 8.24, 95% CI 2.53-26.86) were independently associated with the occurrence of AKI. CONCLUSIONS: AHA with AKI is an increasing problem showing significant morbidity and mortality in Korea. AKI is highly associated with older age, initial thrombocytopenia, PT prolongation, or low serum albumin, and has bad prognostic effect.
