Risk of acute kidney injury after transarterial chemoembolisation in hepatocellular carcinoma patients: A nationwide population-based cohort study
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This nationwide population-based cohort study evaluated the association between acute kidney injury (AKI) and transarterial chemoembolisation (TACE) in patients with hepatocellular carcinoma (HCC).
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.
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.
Our study demonstrates that TACE increases the risk of AKI in patients with HCC without chronic kidney disease or end-stage renal disease.
• 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.
KeywordsAcute kidney injury Transarterial chemoembolisation Hepatocellular carcinoma Nationwide population-based Cohort study
Compliance with ethical standards
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.
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.
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).
Written informed consent was waived by the Institutional Review Board.
• observational study
• performed in the national-wide population-based database
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