Gadour Eyad, Mohamed Tamer, Hassan Zeinab, Hassan Abdalla
Gastroenterology and Hepatology, University Hospitals of Morecambe Bay NHS Foundation Trust, Lancaster, GBR.
Acute Internal Medicine, Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, GBR.
Cureus. 2021 May 28;13(5):e15287. doi: 10.7759/cureus.15287.
Renal and hepatic functions are often mingled through both the existence of associated primary organ diseases and hemodynamic co-relationship. The primary objective of this study was to sum up the relationship between autoimmune hepatitis (AIH) on renal tubular acidosis (RTA) and the stages of the disease. A systematic review was performed for 24 trials. A total of 3687 patients were included. The incidence of RTA occurring and short-term mortality reduction was seen in two groups; for an overall effect: Z = 2.85 (P = 0.004) a total 95% CI of 0.53 [0.34, 0.82]. Only one patient with alcoholic liver cirrhosis was found to have an incomplete type of RTA. Test for overall effect: Z = 2.28 (P = 0.02) 95% CI of 2.83 [1.16, 6.95]. A reduction in fatal infections with dual therapy of corticosteroid plus N-acetylcysteine (NAC) test for overall effect: Z = 3.07 (P = 0.002) with 95% CI of 0.45 [0.27, 0.75]. Autoimmune diseases are the most frequent underlying cause of secondary RTA in adults. The primary renal disease must be actively excluded in all patients with hepatic failure by aggressive clinical and laboratory evaluations.
肾脏和肝脏功能常常通过相关原发性器官疾病的存在以及血流动力学的相互关系而相互关联。本研究的主要目的是总结自身免疫性肝炎（AIH）与肾小管酸中毒（RTA）之间的关系以及疾病的阶段。对24项试验进行了系统评价。共纳入3687例患者。两组均观察到RTA的发生率及短期死亡率降低；总体效应：Z = 2.85（P = 0.004），总95%CI为0.53[0.34, 0.82]。仅发现1例酒精性肝硬化患者患有不完全型RTA。总体效应检验：Z = 2.28（P = 0.02），95%CI为2.83[1.16, 6.95]。皮质类固醇加N - 乙酰半胱氨酸（NAC）联合治疗可降低致命感染率，总体效应检验：Z = 3.07（P = 0.002），95%CI为0.45[0.27, 0.75]。自身免疫性疾病是成人继发性RTA最常见的潜在病因。对于所有肝功能衰竭患者，必须通过积极的临床和实验室评估来主动排除原发性肾脏疾病。
