Prognostic factors for acute kidney injury following transarterial chemoembolization in patients with hepatocellular carcinoma

Int J Clin Exp Pathol. 2014 Apr 15;7(5):2579-86. eCollection 2014.

Abstract

Purpose: Transarterial chemoembolization (TACE) is an effective treatment for patients with unresectable hepatocellular carcinoma (HCC). However, acute kidney injury (AKI) is a severe complication that commonly occurs in patients undergo TACE. In this study, we aim to investigate the incidence and risk factors associated with AKI in HCC patients received TACE treatment.

Methods: This study enrolled 380 HCC patients who received a total of 453 TACE treatments. The incidence, clinical outcomes and risk factors of AKI were examined.

Results: The incidence of post-TACE AKI was 9.05% (41/453). Of these, 3 patients (7.3%) progressed to chronic kidney failure while 7 patients (17.1%) died within 1 month of TACE. The Child-Pugh score (OR=3.784, 95% CI 1.899-7.542, p=0.000), pre-operative serum uric acid (OR=1.450, 95% CI 1.202-1.750, p=0.000), and proteinuria (OR=2.393, 95% CI 1.139-5.031, p=0.021) were independent risk factors for the development of post-TACE AKI.

Conclusion: AKI is a common complication in HCC patients received TACE. The Child-Pugh score, preoperative serum uric acid and proteinuria may be used to predict the risk of post-TACE AKI in HCC patients undergo TACE.

Keywords: AKI; HCC; TACE; kidney failure; liver cancer.

MeSH terms

  • Acute Kidney Injury / diagnosis
  • Acute Kidney Injury / etiology*
  • Acute Kidney Injury / mortality
  • Adult
  • Aged
  • Carcinoma, Hepatocellular / blood
  • Carcinoma, Hepatocellular / mortality
  • Carcinoma, Hepatocellular / therapy*
  • Chemoembolization, Therapeutic / adverse effects*
  • Chemoembolization, Therapeutic / mortality
  • China / epidemiology
  • Disease Progression
  • Female
  • Humans
  • Incidence
  • Kidney Failure, Chronic / etiology
  • Liver Neoplasms / blood
  • Liver Neoplasms / mortality
  • Liver Neoplasms / therapy*
  • Male
  • Middle Aged
  • Proteinuria / complications
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Time Factors
  • Treatment Outcome
  • Uric Acid / blood

Substances

  • Uric Acid