Initial laboratory predictors of severe hepatitis and acute kidney injury in patients with acute hepatitis A

The number of adult patients with acute hepatitis A (AH-A) has markedly increased during the last 10 years in Korea. Of special note, an increase in severe complications of AH-A, such as severe liver dysfunction and acute kidney injury (AKI), has emerged as a significant problem. The objective of this study was to identify the initial predictors for development of severe AH-A and AKI in AH-A. We retrospectively reviewed the medical records of 194 patients with AH-A from January 2007 to March 2009. Severe AH-A and AKI developed in 16 (9.3%) and 11 (6.4%) patients, respectively. Independent predictors for severe AH-A were low albumin [odds ratio (OR), 10.91; 95% confidence interval (CI), 2.324−51.215; P = 0.002], low total cholesterol (OR, 5.54; 95% CI, 1.389−22.113; P = 0.015), and elevated alanine aminotransferase (OR, 20.87; 95% CI, 4.581–95.067; P < 0.001). Also, high level of C-reactive protein was independently associated with AKI occurrence in AH-A (OR, 10.91; 95% CI, 2.324−51.215; P = 0.002).