Effect of Frequent Computed Tomography Examinations with Contrast Media on the Renal Function of Patients with Oral Squamous Cell Cancer and an Evaluation of Risk Factors for Post-Operative Chronic Kidney Disease.

ABSTRACT

Purpose: This retrospective study aimed to investigate the effect of frequent computed tomography (CT) examinations with contrast media on the renal function of patients with oral squamous cell cancer (OSCC) that underwent radical surgery, by using estimated glomerular filtration rate (eGFR); to identify risk factors of occurrence of post-operative chronic kidney disease (CKD) in these patients; and to explore the relationship between risk factors and occurrence of postoperative CKD during follow-up. Methods: Herein, 188 patients (107 male; 81 female) who underwent radical surgery for OSCC were included. We evaluated the risk factors for postoperative CKD after treatment, including demographic, perioperative, and postoperative factors by univariate and multivariate analyses. Patients were divided into post-operative CKD and control groups based on eGFR evaluation. Overall survival (OS) rates were compared between the groups. Results: eGFR decreased over time after treatment in both patient groups. Postoperative CKD was diagnosed in 56 (29.8%) patients. The average number of contrast-enhanced CT examinations was not an independent risk factor for postoperative CKD. However, lower hemoglobin on hospital discharge [odds ratio (OR) = 0.53], lower eGFR on hospital discharge (OR = 0.84), and common use of nonsteroidal anti-inflammatory drugs (OR = 48.79) were significant risk factors associated with postoperative CKD. The control group was associated with a better OS than the postoperative CKD group; however, this difference was not significant. Conclusions: Clinicians should pay close attention to these risk factor of post-operative CKD during the management of patients with OSCC that undergo radical surgery and frequent follow-up CT examinations with contrast media.