Incidence And Risk Factors Of Contrast Nephropathy After Tace In Patients With Liver Cancer And Chronic Kidney Disease.

IF 1.2 4区医学 Q4 MEDICINE, RESEARCH & EXPERIMENTAL

Clinical and Investigative Medicine Pub Date : 2021-10-03 DOI:10.25011/cim.v44i3.36961

Kun-Kun Cao, Ning Ding, Xiao-We Li, Jia-Ming Zhong, Jian Zhai, Zeng-Qiang Qu, Xiao-Li Zhang

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引用次数: 0

Abstract

Purpose: Incidence of contrast induced nephropathy (CIN) and related risk factors in patients with liver cancer and chronic kidney disease after trans-catheter arterial chemoembolization (TACE) is higher. The purpose of this study was to investigate the feasibility and safety of TACE therapy in such patients.

Methods: A retrospective analysis was performed on 103 patients with liver cancer and chronic kidney disease who underwent TACE treatments. TACE was performed according to Seldinger's technique of arterial embolization with minor modifications. Based on CIN diagnostic criteria, patients were divided into non-CIN (n=89) and CIN (n=14) groups. Multiple clinical parameters were assessed for the two groups after TACE. Serum creatinine levels were measured 48-72 h after TACE.

Results: Tumor size (>5 cm), TACE frequency, contrast agent dosage, solitary kidney, volume of iodized oil used in the TACE (ml) and urea levels were significantly higher in CIN group in comparison with the non-CIN group, while serum albumin and haemoglobin levels were significantly lower. Multivariate logistic regression analysis confirmed that the volume of iodized oil and TACE frequency were significantly positively correlated, and serum albumin level was negatively correlated in the CIN group.

Conclusion: Volume of iodized oil, TACE frequency and low serum albumin levels were found to be independent risk factors for CIN after TACE. Thus, it is safe and feasible for hepatocellular carcinoma patients with chronic kidney disease to receive TACE treatment, but adverse events management after TACE needs to be addressed.

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肝癌和慢性肾脏疾病患者经Tace后造影剂肾病的发生率及危险因素

目的:肝癌合并慢性肾病患者经导管动脉化疗栓塞(TACE)后造影剂肾病(CIN)及相关危险因素的发生率较高。本研究的目的是探讨TACE治疗此类患者的可行性和安全性。方法:回顾性分析103例肝癌合并慢性肾脏病患者行TACE治疗的临床资料。TACE采用Seldinger动脉栓塞技术，稍作修改。根据CIN诊断标准，将患者分为非CIN组(n=89)和CIN组(n=14)。对两组TACE术后的多项临床参数进行评估。TACE后48-72 h测定血清肌酐水平。结果:与非CIN组相比，CIN组肿瘤大小(>5 cm)、TACE频率、造影剂用量、孤立肾、TACE中碘化油体积(ml)和尿素水平显著升高，血清白蛋白和血红蛋白水平显著降低。多因素logistic回归分析证实，CIN组碘油体积与TACE频率呈显著正相关，血清白蛋白水平呈负相关。结论:碘油用量、TACE频率和低血清白蛋白水平是TACE术后发生CIN的独立危险因素。因此，肝细胞癌合并慢性肾脏疾病患者接受TACE治疗是安全可行的，但TACE后的不良事件管理有待解决。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical and Investigative Medicine 医学-医学：研究与实验

CiteScore

1.50

自引率

12.50%

发文量

审稿时长

>12 weeks

期刊介绍： Clinical and Investigative Medicine (CIM), publishes original work in the field of Clinical Investigation. Original work includes clinical or laboratory investigations and clinical reports. Reviews include information for Continuing Medical Education (CME), narrative review articles, systematic reviews, and meta-analyses.