The Changes Of Renal Biochemical Markers In Drug-induced Liver Injury And Its Clinical Significance

Objective: To investigate the changes of renal function in drug-induced liver injury(DILI)and its clinical significance.Subjects and Methods: A retrospective analysis was performed to collect inpatients with primary or secondary diagnosis of DILI from January 2011 to December 2016 in the First Affiliated Hospital of China Medical University.The entry and exclusion criteria were in accordance with the 2015 edition of DILI's diagnosis and treatment guidelines designed by the Chinese Medical Association of liver disease credits.Experimental group included 430 patients with RUCAM score > 6.Healthy control group included 410 cases whose physical examination report showed “no abnormalities” at the same time.Data collected included general clinical data such as gender,age,current illness history,past history(infectious disease history,history of disease),medication history,etc.blood biochemical indicators such as liver function,renal function,glomerular filtration rate and so on.The t test was used to compare normal distribution data between two groups.Mann-Whitney test was used to compare non-normal distribution data between two groups.p<0.05 was statistically difference.Results: The level of Cr and Urea in DILI group was lower than that in the healthy control group(51? mol/L vs 59 ? mol/L,3.89mmol/L vs 4.96mmol/L),and the Cys-C level was higher than that of the healthy control group(0.97mg/L vs 0.80mg/L)(p<0.05).Cr and Urea in the patients aged<75 were lower than those of the control group(p<0.05).and there was no significant difference between those aged>75.Cys-C at all ages of DILI were higher than those of the control group(p<0.05).DILI in<60 years old were higher than the control group,and there was no significant difference in>60 years old.No evidence between renal function and the time of drug using was found.The most obvious reduction in Cr was antithyroid drugs,followed by antituberculous drugs.The most obvious reduction in Urea was herbal medicine.Cys-C was increased mostly in nonsteroidal anti-inflammatory drugs(NSAIDs)and in cholestasis group(p<0.05).Conclusion:Early changes of DILI in renal function were significantly lower in Cr and Urea and significantly higher in Cys-C.e GFR can't be used as an indicator of early DILI.