ACUTE KIDNEY INJURY ASSOCIATED WITH ACUTE VIRAL HEPATITIS A

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ACUTE KIDNEY INJURY ASSOCIATED WITH ACUTE VIRAL HEPATITIS A

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Co-author 1

K Naja najak141101@gmail.com Government medical college Calicut Nephrology Calicut India *

Co-author 2

Jayakumar E K drjayakumarek@gmail.com Government medical college Calicut Nephrology Calicut India -

Co-author 3

Umashankar P umasankarantirur@gmail.com Government medical college Calicut Pathology Calicut India -

Co-author 4

Hijaz P T hijazptkpm@yahoo.co.in Government medical college Calicut Nephrology Calicut India -

Co-author 5

Noushad T P drtpnoushad@yahoo.co.in Government medical college Calicut Nephrology Calicut India -

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Introduction

Acute viral hepatitis A is an infectious disease that typically follows a self-limiting course. While extrahepatic manifestations are relatively rare, acute renal failure has been documented in some cases. Causes of AKI include dehydration secondary to vomiting and bile cast nephropathy. We aimed to study AKI in acute viral hepatitis A using renal biopsy.

Methods

A cross-sectional study was conducted in patients with acute viral hepatitis A presenting to the nephrology department from January 2024 to January 2025. Renal biopsy was done with 18G biopsy needle and was sent for light microscopy and immunofluorescence.

Results

Between January 2024 and January 2025, 47 patients were admitted with AKI associated with acute viral hepatitis. Renal biopsy was done in 10 patients, 9 men and 1 woman. Mean age was 33.5 ± 5.3. 2 were diabetic and 2 had history of recent alcohol consumption. Only 1 patient had pedal oedema. 9 had oliguria. 8 patients had proteinuria and 8 microscopic haematuria. Median and mean value of peak ALT and creatinine were 2370(268-5768) and 10.1±3.6 respectively. Low C3 level was present in 7 patients. 9 out of 10 patients underwent haemodialysis with a mean of 7.2±5.1 sessions. Kidney biopsy results showed bile casts in all cases, acute tubulo-interstitial nephritis in all 10 cases(Fig A). 2 cases showed IgA nephropathy in renal biopsy(Fig B).

Conclusion

Fig A. Bile casts in tubules Fig B. Mild increase in mesangial cellularity with 2+ to 3+ IgA deposition in the mesangium

Bilirubin cast nephropathy is a common cause for AKI in viral hepatitis A in our study. Secondary IgA nephropathy should also be considered in patients presenting with viral hepatitis A and AKI.

This abstract was also submitted for the WINICON 2025 held in Chennai

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