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

  • Mari Aoe
  • Takafumi Kanemitsu
  • Takamasa Ohki
  • Satoru Kishi
  • Yoshiyasu Ogura
  • Yuto Takenaka
  • Toyohiro Hashiba
  • Hiroko Ambe
  • Emi Furukawa
  • Yu Kurata
  • Masahiro Ichikawa
  • Ken Ohara
  • Tomoko Honda
  • Satoshi Furuse
  • Katsunori Saito
  • Nobuo Toda
  • Naobumi MiseEmail author
Original article
  • 4 Downloads

Abstract

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.

Keywords

Contrast-induced nephropathy (CIN) Transarterial chemoembolisation (TACE) Hepatocellular carcinoma (HCC). 

Notes

Compliance with ethical standards

Conflict of interest

The authors have declared that no conflict of interest exists.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee at which the studies were conducted (the ethics committee of Mitsui Memorial Hospital Approval No. C30 [Year 2018]) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

This study is a retrospective observational study using existing data from medical records. IRB waived the requirement for informed consent from the patients according to the ethical guidelines for medical and health research involving human subjects in Japan.

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Copyright information

© Japanese Society of Nephrology 2019

Authors and Affiliations

  • Mari Aoe
    • 1
  • Takafumi Kanemitsu
    • 1
  • Takamasa Ohki
    • 1
  • Satoru Kishi
    • 1
  • Yoshiyasu Ogura
    • 1
  • Yuto Takenaka
    • 1
  • Toyohiro Hashiba
    • 1
  • Hiroko Ambe
    • 1
  • Emi Furukawa
    • 1
  • Yu Kurata
    • 1
  • Masahiro Ichikawa
    • 1
  • Ken Ohara
    • 1
  • Tomoko Honda
    • 1
  • Satoshi Furuse
    • 1
  • Katsunori Saito
    • 1
  • Nobuo Toda
    • 1
  • Naobumi Mise
    • 1
    Email author
  1. 1.Division of Internal MedicineMitsui Memorial HospitalTokyoJapan

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