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Impact of low serum hemoglobin on development of contrast-induced nephropathy (CIN) in patients with hepatocellular carcinoma (HCC) following transarterial chemoembolisation (TACE)

  • Nephrology - Original Paper
  • Published:
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Abstract

Objectives

To assess the association between low hemoglobin (Hb) level and development of contrast-induced nephropathy (CIN) for hepatocellular carcinoma (HCC) patients after transarterial chemoembolization (TACE).

Methods

A retrospective analysis was performed on 284 patients undergoing 503 consecutive sessions of TACE. Propensity score matching (PSM) analysis was used to reduce the influence of the difference in variables in normal and low hemoglobin groups. Risk factors of CIN were assessed by univariate and multivariate logistic regression analysis. The relation between Hb level and CIN development was analyzed by receiver operating characteristic (ROC) curve.

Results

CIN developed in 5.6% patients after TACE. Multivariate logistic regression analysis showed that hypertension, Hb and serum creatinine (Scr) were independent risk factors for the development of post-TACE CIN. Grouped by normal or low Hb, the incidence of CIN was 14.6% (16/110) in the low Hb group and 3.4% (4/116) in the normal Hb group after PSM. Multivariate logistic regression analysis revealed that Hb, lymphocyte count, and neutrophil to lymphocyte ratio (NLR) were independent risk factors for the development of post-TACE CIN. The optimal cut-off point at which the Hb concentration resulted in a high probability of developing CIN was 105.5 g/L in males.

Conclusions

Low Hb is an independent risk factor for post-TACE CIN. Therefore, HCC patients with low Hb levels should be closely monitored before and during TACE.

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Data availability

The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.

Abbreviations

CIN:

Contrast-induced nephropathy

HCC:

Hepatocellular carcinoma

TACE:

Transarterial chemoembolization

PCI:

Percutaneous coronary interventions

ROC:

Receiver operating characteristic

PSM:

Propensity score matching

WBC:

White blood cell

Hb:

Hemoglobin

PLT:

Platelet

ALT:

Alanine transaminase

AST:

Aspartate transaminase

GGT:

γ-Glutamyl transpeptadase

BUN:

Blood urea nitrogen

Scr:

Serum creatinine

NLR:

Neutrophil to lymphocyte ratio

Hb-N:

Normal hemoglobin

Hb-L:

Low hemoglobin

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Acknowledgements

The authors gratefully appreciate the assistance of Fanyong Qu, Jiuning Huang and Shuping Zhang (Department of Radiation Oncology, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, 264100, Shandong, China).

Funding

This study was supported by National Key R&D Development of China Project (Grant number: 2017YFC0113403), National Natural Science Foundation of China (Grant number: 81571635) and Binzhou Medical University Research Program and Research Foundation Project (Grant number: BY2018KJ30).

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Authors and Affiliations

  1. Department of Radiology, First Affiliated Hospital of China Medical University, Shenyang, 110001, Liaoning, China

    Youjiao Si, Wenge Sun, Xianchuang Liu & Ke Ren

  2. Department of Radiology, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, 264100, Shandong, China

    Youjiao Si

  3. Department of Radiation Oncology, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, 264100, Shandong, China

    Kaikai Zhao

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  1. Youjiao Si
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  2. Wenge Sun
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  3. Kaikai Zhao
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  4. Xianchuang Liu
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  5. Ke Ren
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Contributions

YS: data collection, statistics, original draft. WS, KZ and XL: data collection. KR: monitor the clinical trial.

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Correspondence to Ke Ren.

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Si, Y., Sun, W., Zhao, K. et al. Impact of low serum hemoglobin on development of contrast-induced nephropathy (CIN) in patients with hepatocellular carcinoma (HCC) following transarterial chemoembolisation (TACE). Int Urol Nephrol 53, 1189–1195 (2021). https://doi.org/10.1007/s11255-020-02712-7

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  • DOI: https://doi.org/10.1007/s11255-020-02712-7

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