ISSN:
1365-2036
Source:
Blackwell Publishing Journal Backfiles 1879-2005
Topics:
Medicine
Notes:
Background : Transarterial chemoembolization is effective for hepatocellular carcinoma. Acute renal failure may occur after transarterial chemoembolization because of radiocontrast agent, but its clinical aspects are unknown.Aim : To investigate the incidence, risk factors and outcome of acute renal failure, defined as increase of serum creatinine 〉 1.5 mg/dL, after transarterial chemoembolization.Methods : A total of 235 hepatocellular carcinoma patients with 843 transarterial chemoembolization treatment sessions were analysed.Results : Acute renal failure developed in 56 (23.8%) patients and the estimated risk of developing acute renal failure was 6.6% in each treatment session. Comparison between the episodes of transarterial chemoembolization with and without acute renal failure by using the generalized estimating equation disclosed that Child–Pugh class B (odds ratio: 2.6, P = 0.007) and treatment session (odds ratio: 1.3; P 〈 0.0001) were independent risk factors of acute renal failure. Twenty-seven patients had prolonged renal function impairment. Multivariate analysis by generalized estimating equation showed that Child–Pugh class B (odds ratio: 4.3, P = 0.0004) and diabetes mellitus (odds ratio: 5.2, P 〈 0.0001) were linked with prolonged acute renal failure, which independently predicted a decreased survival (relative risk: 2.3, P = 0.002).Conclusions : Acute renal failure after transarterial chemoembolization appears to be dose-related and is associated with the severity of cirrhosis. Patients with diabetes mellitus or Child–Pugh class B more frequently develop prolonged acute renal failure, which in turn is a poor prognostic predictor.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1111/j.1365-2036.2004.01936.x
