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Risk of acute kidney injury after transarterial chemoembolisation in hepatocellular carcinoma patients: A nationwide population-based cohort study

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Abstract

Objective

This nationwide population-based cohort study evaluated the association between acute kidney injury (AKI) and transarterial chemoembolisation (TACE) in patients with hepatocellular carcinoma (HCC).

Methods

The case cohort included patients with HCC who had undergone TACE treatment between 1 January 1998 and 31 March 2010. Patients with baseline chronic kidney disease, with baseline end-stage renal disease, and aged younger than 20 years were excluded. HCC patients with TACE and HCC patients without TACE were matched 1:1 in terms of propensity scores.

Results

A total of 1132 HCC patients with TACE and 1132 HCC patients without TACE (controls) were enrolled, of which 72 and 66 patients developed AKI, respectively. After adjustment for age, sex, comorbidity, and other medications, the risk of AKI was higher in HCC patients with TACE [hazard ratio (HR) = 1.66, 95% CI = 1.17–2.34]. The HRs of post-TACE AKI were 1.56 (95% CI = 1.02–2.37) and 1.74 (95% CI = 1.23–2.48) for patients having at least one comorbidity and less frequent sessions of TACE (≤3 times), respectively.

Conclusions

Our study demonstrates that TACE increases the risk of AKI in patients with HCC without chronic kidney disease or end-stage renal disease.

Key points

• Seventy-two of1132 patients with TACE and 62/1132 patients without TACE developed AKI.

• AKI risk was higher in HCC patients with TACE.

• HRs were 1.56 and 1.74 for those with comorbidities and less frequent TACE.

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Author information

Authors and Affiliations

  1. Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan

    Bo-Ching Lee & Kao-Lang Liu

  2. School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan

    Cheng-Li Lin

  3. Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan

    Cheng-Li Lin

  4. Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, No. 2, Yuh-Der Road, Taichung, 40447, Taiwan, Republic of China

    Chia-Hung Kao

  5. Department of Nuclear Medicine and PET Centre, China Medical University Hospital, Taichung, Taiwan

    Chia-Hung Kao

  6. Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan

    Chia-Hung Kao

Authors
  1. Bo-Ching Lee
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  2. Kao-Lang Liu
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  3. Cheng-Li Lin
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  4. Chia-Hung Kao
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Corresponding author

Correspondence to Chia-Hung Kao.

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Guarantor

The scientific guarantor of this publication is Prof. Chia-Hung Kao.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Funding

This study is supported in part by the Taiwan Ministry of Health and Welfare Clinical Trial and Research Center of Excellence (MOHW106-TDU-B-212-113004), China Medical University Hospital, Academia Sinica Taiwan Biobank Stroke Biosignature Project (BM10501010037), NRPB Stroke Clinical Trial Consortium (MOST105-2325-B-039-003), Tseng-Lien Lin Foundation, Taichung, Taiwan, Taiwan Brain Disease Foundation, Taipei, Taiwan, and Katsuzo and Kiyo Aoshima Memorial Funds, Japan, and Health and Welfare Surcharge of Tobacco Products, China Medical University Hospital Cancer Research Center of Excellence (MOHW105-TDU-B-212-134003, Taiwan). The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. No additional external funding was received for this study.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Ethical approval

This study was approved to fulfill the condition for exemption by the Institutional Review Board (IRB) of China Medical University (CMUH-104-REC2-115-CR1).

Informed consent

Written informed consent was waived by the Institutional Review Board.

Methodology

• retrospective

• observational study

• performed in the national-wide population-based database

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Lee, BC., Liu, KL., Lin, CL. et al. Risk of acute kidney injury after transarterial chemoembolisation in hepatocellular carcinoma patients: A nationwide population-based cohort study. Eur Radiol 27, 4482–4489 (2017). https://doi.org/10.1007/s00330-017-4893-x

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  • DOI: https://doi.org/10.1007/s00330-017-4893-x

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