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. 1978 Jul 29;2(6133):338–341. doi: 10.1136/bmj.2.6133.338

Renal failure in otherwise uncomplicated acute viral hepatitis.

S P Wilkinson, M H Davies, B Portmann, R Williams
PMCID: PMC1606474  PMID: 687905

Abstract

Twelve patients with otherwise uncomplicated acute viral hepatitis (two were HBsAg-positive) developed renal failure. Apart from dehydration due to repeated vomiting in one patient, no factor responsible for precipitating renal failure could be identified. The clinical course was characterised by renal failure with plasma urea concentrations reaching maximum values of 26-69 mmol/l (175-416 mg/100 ml). Ten patients needed dialysis for up to two weeks. Seven patients recovered completely, while the other five died from sepsis. The types of renal failure were similar to those described in fulminant hepatic failure and cirrhosis--namely, functional renal failure in five patients and acute tubular necrosis in seven. Two of the patients with functional renal failure later developed tubular necrosis. The mechanism responsible for renal failure in acute viral hepatitis is uncertain, though endotoxaemia may contribute.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bowyer A., McColl I. The role of erythrasma in pruritus ani. Lancet. 1966 Sep 10;2(7463):572–573. doi: 10.1016/s0140-6736(66)93039-x. [DOI] [PubMed] [Google Scholar]
  2. CONRAD M. E., SCHWARTZ F. D., YOUND A. A. INFECTIOUS HEPATITIS; A GENERALIZED DISEASE. A STUDY OF RENAL, GASTROINTESTINAL AND HEMATOLOGIC ABNORMALITIES. Am J Med. 1964 Nov;37:789–801. doi: 10.1016/0002-9343(64)90027-0. [DOI] [PubMed] [Google Scholar]
  3. Combes B., Shorey J., Barrera A., Stastny P., Eigenbrodt E. H., Hull A. R., Carter N. W. Glomerulonephritis with deposition of Australia antigen-antibody complexes in glomerular basement membrane. Lancet. 1971 Jul 31;2(7718):234–237. doi: 10.1016/s0140-6736(71)92572-4. [DOI] [PubMed] [Google Scholar]
  4. Dittrich P. Partialfunktionen der Niere bei Hepatitis epidemica und Verschlussikterus. Klin Wochenschr. 1966 Apr 15;44(8):441–446. doi: 10.1007/BF01727459. [DOI] [PubMed] [Google Scholar]
  5. Feinstone S. M., Kapikian A. Z., Purcell R. H., Alter H. J., Holland P. V. Transfusion-associated hepatitis not due to viral hepatitis type A or B. N Engl J Med. 1975 Apr 10;292(15):767–770. doi: 10.1056/NEJM197504102921502. [DOI] [PubMed] [Google Scholar]
  6. Kennedy A. C., Burton J. A., Luke R. G., Briggs J. D., Lindsay R. M., Allison M. E., Edward N., Dargie H. J. Factors affecting the prognosis in acute renal failure. A survey of 251 cases. Q J Med. 1973 Jan;42(165):73–86. [PubMed] [Google Scholar]
  7. Kleinknecht D., Jungers P., Chanard J., Barbanel C., Ganeval D., Rondon-Nucete M. Factors influencing immediate prognosis in acute renal failure, with special reference to prophylactic hemodialysis. Adv Nephrol Necker Hosp. 1971;1:207–230. [PubMed] [Google Scholar]
  8. SALOMON M. I., SAKAGUCHI H., CHURG J., DACHS S., GRISHMAN E., MAUTNER W., PARONETTO F., ROSENTHAL W. S. RENAL LESIONS IN HEPATIC DISEASE: A STUDY BASED ON KIDNEY BIOPSIES. Arch Intern Med. 1965 Jun;115:704–709. doi: 10.1001/archinte.1960.03860180076013. [DOI] [PubMed] [Google Scholar]
  9. SHEAR L., KLEINERMAN J., GABUZDA G. J. RENAL FAILURE IN PATIENTS WITH CIRRHOSIS OF THE LIVER. I. CLINICAL AND PATHOLOGIC CHARACTERISTICS. Am J Med. 1965 Aug;39:184–198. doi: 10.1016/0002-9343(65)90041-0. [DOI] [PubMed] [Google Scholar]
  10. Stott R. B., Cameron J. S., Ogg C. S., Bewick M. Why the persistently high mortality in acute renal failure. Lancet. 1972 Jul 8;2(7767):75–79. doi: 10.1016/s0140-6736(72)91562-0. [DOI] [PubMed] [Google Scholar]
  11. Triger D. R., Alp M. H., Wright R. Bacterial and dietary antibodies in liver disease. Lancet. 1972 Jan 8;1(7741):60–63. doi: 10.1016/s0140-6736(72)90061-x. [DOI] [PubMed] [Google Scholar]
  12. WOLFF H. P., KOCZOREK K. R., BUCHBORN E. Aldosterone and antidiuretic hormone (adiuretin) in liver disease. Acta Endocrinol (Copenh) 1958 Jan;27(1):45–58. doi: 10.1530/acta.0.0270045. [DOI] [PubMed] [Google Scholar]
  13. Wilkinson S. P., Arroyo V., Gazzard B. G., Moodie H., Williams R. Relation of renal impairment and haemorrhagic diathesis to endotoxaemia in fulminant hepatic failure. Lancet. 1974 Mar 30;1(7857):521–524. doi: 10.1016/s0140-6736(74)92711-1. [DOI] [PubMed] [Google Scholar]
  14. Wilkinson S. P., Blendis L. M., Williams R. Frequency and type of renal and electrolyte disorders in fulminant hepatic failure. Br Med J. 1974 Feb 2;1(5900):186–189. doi: 10.1136/bmj.1.5900.186. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Wilkinson S. P., Portmann B., Hurst D., Williams R. Pathogenesis of renal failure in cirrhosis and fulminant hepatic failure. Postgrad Med J. 1975 Aug;51(598):503–505. doi: 10.1136/pgmj.51.598.503. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Wilkinson S. P., Weston M. J., Parsons V., Williams R. Dialysis in the treatment of renal failure in patients with liver disease. Clin Nephrol. 1977 Jul;8(1):287–292. [PubMed] [Google Scholar]

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