Abstract: OBJECTIVE: To compare the causes, clinical symptoms, laboratory test results, and prognosis in patients with acute liver failure(ALF) induced by traditional Chinese medicines(TCM) and by Western Medicines(WM).METHODS: The medical histories of patients who were diagnosed with drug-induced ALF(DALF)(n =96) after hospitalization in the 302 Military Hospital between January 2010 and December 2015 were retrospectively examined.RESULTS: Fifty-eight of the 96 DALF patients(60.4%) had a hepatocellular pattern of DALF, 16 patients(16.7%) had a cholestatic pattern, and 22 patients(22.9%) had a mixed pattern. DALF resolved in 24 patients(25.0%). Twenty-five patients(26.0%)developed chronic liver injury, 43 patients(44.8%)died, and 4 patients(4.2%) underwent liver transplantation. There were 42 ALF patients(43.8%) who received WM, and 32 ALF patients(33.3%) who received TCM. TCM-induced ALF patients had a higher average age [42.4 ± 18.4) vs(33.5 ± 17.9) years,P = 0.04] and higher creatinine and urine nitrogen levels [(155.2 ± 108.8) vs(97.5 ± 130.4) mmol/L, P =0.047;(9.1 ± 7.7) vs(4.3 ± 5.0) mmol/L, P = 0.002, respectively]. Patients with TCM-induced ALF exhibited an increased risk of renal injury [odds ratio(OR),3.75; 95% confidence interval(CI), 1.330-10.577].The 14 patients with TCM-induced ALF who died exhibited higher creatinine levels than the 18 patients with TCM-induced ALF patients who survived[(218.7 ± 111.6) vs(105.8 ± 78.4) mmol/L, P =0.002]. They were also more likely to exhibit ascites(85.7% vs 44.4%, P = 0.017) and hepatorenal syndrome(78.6% vs 22.2%, P = 0.002).CONCLUSION: TCM-induced ALF was more likely to be accompanied by renal injury than was WM-induced ALF, especially in TCM-induced ALF patients who died.

Key words: Drug-induced liver injury, Jaundice, obstructive, Medicine, Chinese traditional, Creatinine, Hepatorenal syndrome