Incidence and risk factors of contrast-induced nephropathy after transcatheter arterial chemoembolization in hepatocellular carcinoma

被引:9
作者
Aoe, Mari [1 ]
Kanemitsu, Takafumi [1 ]
Ohki, Takamasa [1 ]
Kishi, Satoru [1 ]
Ogura, Yoshiyasu [1 ]
Takenaka, Yuto [1 ]
Hashiba, Toyohiro [1 ]
Ambe, Hiroko [1 ]
Furukawa, Emi [1 ]
Kurata, Yu [1 ]
Ichikawa, Masahiro [1 ]
Ohara, Ken [1 ]
Honda, Tomoko [1 ]
Furuse, Satoshi [1 ]
Saito, Katsunori [1 ]
Toda, Nobuo [1 ]
Mise, Naobumi [1 ]
机构
[1] Mitsui Mem Hosp, Div Internal Med, 1 Kanda Izumi Cho, Tokyo 1018643, Japan
关键词
Contrast-induced nephropathy (CIN); Transarterial chemoembolisation (TACE); Hepatocellular carcinoma (HCC); ACUTE KIDNEY INJURY; ACUTE-RENAL-FAILURE; TRANSARTERIAL CHEMOEMBOLIZATION; LIVER-FAILURE; EMBOLIZATION;
D O I
10.1007/s10157-019-01751-4
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Background Transcatheter arterial chemoembolization (TACE) is widely used for unresectable hepatocellular carcinoma (HCC). The purpose of this study was to investigate incidence and risk factors of contrast-induced nephropathy (CIN) after TACE in patients with HCC. Methods In this single-center retrospective study, we examined 461 consecutive TACE sessions in 260 patients between January 2003 and October 2015. CIN was defined as an increase in serum creatinine levels by >= 0.5 mg/dl or >= 25% from baseline within 72 h after TACE. We calculated incidence rate of CIN and tried to identify its risk factors by logistic regression analysis. Results Twenty-one cases of CIN (5%) were observed in 461 TACE sessions. One patient required subsequent hemodialysis transiently. In univariate analysis, tumor size > 5 cm [odds ratio (OR) 5.76, 95% confidence interval (CI) 2.34-14.14, p < 0.001], chronic kidney disease (OR 2.54, 95% CI 1.05-6.14, p = 0.04), serum hemoglobin level [OR 0.79 (per 1 g/dl increase), 95% CI 0.64-0.98, p = 0.03] and serum albumin level [OR 0.44 (per 1 g/dl increase), 95% CI 0.19-1.02, p = 0.05] were associated with the development of CIN. Stepwise logistic regression methods showed that tumor size > 5 cm (OR 7.81, 95% CI 2.99-20.46, p < 0.001) and serum albumin [OR 0.29 (per 1 g/dl increase), 95% CI 0.11-0.75, p = 0.01] were risk factors of CIN. Conclusions In this study, HCC tumor size and lower serum albumin level were independent predictors of CIN after TACE.
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页码:1141 / 1146
页数:6
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