Renal failure in acute vival hepatitis

ABSTRACT

Fifty five patients with acute viral hepatitis, 6 of them had fulminant hepatic failure were studied with regard to incidence and types of complicating renal insufficiency. Renal failure was considered to be present when the serum creatinine and/or urea were 227 umol/1 and 12 mmol/1 respectively. Of the patients with acute viral hepatitis 6[12.27%] developed renal failure. In 5 the type was acute tubular necrosis and in one indeterminable. Of the patients with fulminant hepatic failure 5 [88.33%] had renal failure, of these 2 had acute tubular necrosis and in the remaining 3 the type was indeterminable. Hyponatraemia, relative high serum potassium and low urinary potassium was found in fulminant hepatic failure. Creatinine clearance < 25 ml/min was indicative of had prognosis, all patients died. The biochemical liver function test revealed significantly higher AST/ALT ratio in fulminant hepatic failure compared to acute viral hepatitis group. Its value in the prediction of the out-come of the disease has been confirmed. Fulminant hepatic failure occurred as a complication of all the 3 types of hepatitis. The mechanism of renal failure may be the reduced renal blood flow resulting from the vasoconstrictor effect of gut endotoxins which escape the kupffer cell filter