ACUTE KIDNEY INJURY AFTER TRANSARTERIAL CHEMOEMBOLIZATION PROGRESSING TO CHRONIC RENAL FAILURE IN HEPATOCELLULAR CARCINOMA: A RETROSPECTIVE STUDY

초록

Background: Transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC) may result in acute kidney injury (AKI) , some of which does not recover to normal renal function and progress to chronic renal failure(CRF). The clinical course is not unknown in detail Methods: To investigate the incidence, risk factor and outcomes of progression of AKI after TACE to CRF, we retrospectively analyzed 208 TACE treatment sessions in 114 HCC patients. Results: The incidence of AKI in the first 72 h after TACE was 9.6% (11 of 114 patients at risk). Multivariate analysis showed that presence of hypertension (OR 3.24, 95% CI 1.21&#8211;8.72, p =0.02), lower baseline serum albumin (OR 0.29, 95% CI 0.15&#8211;0.56, p <0.01) and higher creatinine level (OR 12.02, 95% CI 3.49&#8211;41.39, p<0 .01) were independent risk factors of CRF after TACE . Prolonged renal insufficiency after 12 month was observed in 45.4% of AKI episodes. Conclusion: Progression of AKI to CRF after TACE appears to be presence of hypertension, low serum level of albumin and high baseline level of creatinine. We suggest prolonged close follow-up of renal function will be required in AKI after TACE in patients with HCC.