Abnormalities in aminotransferase levels during acute pyelonephritis

Liver abnormalities are common in septic patients. The study was aimed at investigating the alterations in aminotransferase levels during acute pyelonephritis in adults. Serum aminotransferases (AST and ALT) were determined in 421 patients (aged 16–90 years, 79.8% females) admitted to the hospital because of acute pyelonephritis. Abnormally high aminotransferase (sAST or sALT) levels were present in 21.4% (95% CI 17.6–25.9%) of patients without pre-existing liver disease (n = 401). Aminotransferase abnormality was moderate in the majority of cases. After adjusting for confounders, aminotransferase abnormality was associated with age and with signs of sepsis (particularly, high body temperature and low blood pressure). Aminotransferase levels tended to normalize during convalescence. In conclusion, the management of patients with pyelonephritis should take into account that moderate and self-limited abnormalities in aminotransferase levels are frequent during the acute phase of the disease.