Patients suffer kidney failure

Kochi: Ernakulam is experiencing an epidemiological transition in the pattern of Hepatitis A infections, which were considered uncomplicated and primarily associated with jaundice. Doctors are now seeing a rise in young patients, mostly between 18 and 40 years old with no pre-existing health conditions, being admitted to ICU with acute renal failure within a week of infection. This severe progression has led to an increase in mortality rates.While acute liver failure (ALF) due to Hepatitis A is rare, acute kidney failure is even rarer. "It was rare for Hepatitis A to affect other organs. But now we are seeing complications due to the involvement of other organs. By and large, a person who gets Hepatitis A develops jaundice and recovers in a few days. However, we are noticing an increase in the number of Hepatitis A cases where there is the involvement of kidneys, leading to renal failure, and other symptoms associated with the liver," said Dr Mathew Jacob, senior consultant, hepato pancreato biliary & abdominal multi-organ transplant, Aster Medcity. Severe cases are becoming more frequent, with hospitals reporting one or two such cases weekly. These patients often require continuous kidney dialysis in the ICU for 4-6 weeks, and the mortality risk rises to 40%. Dr. Jacob added, "Although the liver recovers, kidney failure persists, often leading to death from secondary complications."The incidence of ALF due to Hepatitis A is also rising. Dr Cyriac Abby Philips, a hepatology specialist, stated, "While ALF risk is typically less than 1% in adults with Hepatitis A, I now see on average 10-15 acute cases monthly in my OPD, with 12-14 ICU admissions. Among these, one or two patients are at high risk of ALF.""Most of the patients coming with acute Hepatitis A are very sick. If a place has a high number of Hepatitis A cases, then it indicates that the state is not doing its job properly. The main reason for high Hep A is poor sanitation and water contamination," said Dr Mathew Philip, medical gastroenterologist, Lisie Hospital.
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