Acute renal failure after transarterial chemoembolization for hepatocellular carcinoma: a retrospective study of the incidence, risk factors, clinical course and long-term outcome.
Aliment Pharmacol Ther
; 19(9): 999-1007, 2004 May 01.
Article
in En
| MEDLINE
| ID: mdl-15113367
ABSTRACT
BACKGROUND:
Transarterial chemoembolization is effective for hepatocellular carcinoma. Acute renal failure may occur after transarterial chemoembolization because of radiocontrast agent, but its clinical aspects are unknown.AIM:
To investigate the incidence, risk factors and outcome of acute renal failure, defined as increase of serum creatinine > 1.5 mg/dL, after transarterial chemoembolization.METHODS:
A total of 235 hepatocellular carcinoma patients with 843 transarterial chemoembolization treatment sessions were analysed.RESULTS:
Acute renal failure developed in 56 (23.8%) patients and the estimated risk of developing acute renal failure was 6.6% in each treatment session. Comparison between the episodes of transarterial chemoembolization with and without acute renal failure by using the generalized estimating equation disclosed that Child-Pugh class B (odds ratio 2.6, P = 0.007) and treatment session (odds ratio 1.3; P < 0.0001) were independent risk factors of acute renal failure. Twenty-seven patients had prolonged renal function impairment. Multivariate analysis by generalized estimating equation showed that Child-Pugh class B (odds ratio 4.3, P = 0.0004) and diabetes mellitus (odds ratio 5.2, P < 0.0001) were linked with prolonged acute renal failure, which independently predicted a decreased survival (relative risk 2.3, P = 0.002).CONCLUSIONS:
Acute renal failure after transarterial chemoembolization appears to be dose-related and is associated with the severity of cirrhosis. Patients with diabetes mellitus or Child-Pugh class B more frequently develop prolonged acute renal failure, which in turn is a poor prognostic predictor.
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Database:
MEDLINE
Main subject:
Chemoembolization, Therapeutic
/
Carcinoma, Hepatocellular
/
Acute Kidney Injury
/
Liver Neoplasms
Type of study:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Year:
2004
Type:
Article