Abstract
Purpose: The purpose of this retrospective study was to assess the incidence and the risk factors of contrast-induced nephropathy (CIN) following transcatheter arterial chemoembolization (TACE) in patients with hepatocellular carcinoma (HCC). Materials and Methods: We performed a retrospective review of 186 sessions of TACE in 122 patients with HCC. We examined the incidence and factors associated with risk of CIN, defined as an increase of at least 0.5 mg/dl (44.2 μmol/l) or 25% of the baseline serum creatinine level between 48 and 72 hours after TACE. Results: CIN developed in 14 (7.5%) of the 186 sessions after TACE. A univariate analysis showed that the Child-Pugh class B or C [10/14 (71%) vs. 70/172 (41%), P = 0.046], a low albumin level (3.0 ± 0.5 vs. 3.4 ± 0.6, P = 0.018), and a low hemoglobin level (10.6 ± 2.0 vs. 11.8 ± 2.0, P = 0.035) were significantly associated with the development of CIN. Multivariate analysis revealed that the hemoglobin value was associated with CIN [odds ratio (OR) 1.6; P = 0.038]. Conclusions: CIN after TACE is closely associated with the severity of liver cirrhosis, and with low levels of albumin and hemoglobin. Effective preventive methods remain to be considered in patients with HCC and advanced LC who are undergoing TACE.
Highlights
Hepatocellular carcinoma (HCC) is one of the most common malignant diseases in the world, and its incidenceHow to cite this paper: Murakami, R., Saito, H., Miki, I., Yasui, D., Sugihara, F., Ueda, T., Murata, S., Hayashi, H. and Kumita, S. (2016) Contrast-Induced Nephropathy in Patients with Hepatocellular Carcinoma Undergoing Transcatheter Arterial Chemoembolization
843 patients undergoing Transcatheter arterial chemoembolization (TACE) was 6.6% [13], the definition of contrast-induced nephropathy (CIN) being an abrupt increase of ≥50% over the baseline, or an absolute increase of ≥0.5 mg/dl, in the serum creatinine level
Another study reported that the incidence of CIN in 236 patients undergoing TACE was 9.8%, CIN being defined as an abrupt increase of ≥50% over the baseline, or an absolute increase of ≥0.3 mg/dl, in the serum creatinine level [14]
Summary
Hepatocellular carcinoma (HCC) is one of the most common malignant diseases in the world, and its incidenceHow to cite this paper: Murakami, R., Saito, H., Miki, I., Yasui, D., Sugihara, F., Ueda, T., Murata, S., Hayashi, H. and Kumita, S. (2016) Contrast-Induced Nephropathy in Patients with Hepatocellular Carcinoma Undergoing Transcatheter Arterial Chemoembolization. (2016) Contrast-Induced Nephropathy in Patients with Hepatocellular Carcinoma Undergoing Transcatheter Arterial Chemoembolization. HCC is diagnosed at an early stage in 30% - 40% of all patients, when it is amenable to treatment such as surgical resection, liver transplantation and local ablative treatments [1] [2]. Transcatheter arterial chemoembolization (TACE) has been recognized as an effective palliative treatment option for patients in whom surgical or local ablative treatment is contraindicated; it currently plays a major role in treating advanced HCC [4] [5]. Patients with HCC frequently have advanced liver cirrhosis (LC), which in advanced cases is characterized by peripheral vasodilatation associated with decreased renal perfusion due to activation of the vasoconstrictor system [6] [7]. LC may be a predisposing factor for declining renal function
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