Risk of acute kidney injury after transarterial chemoembolisation in hepatocellular carcinoma patients: A nationwide population-based cohort study

Abstract

Objective: This nationwide population-based cohort study evaluated the association between acute kidney injury (AKI) and transarterial chemoembolisation (TACE) in patients with hepatocellular carcinoma (HCC).

Methods: 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.

Results: 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.

Conclusions: Our study demonstrates that TACE increases the risk of AKI in patients with HCC without chronic kidney disease or end-stage renal disease.

Key points: • 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.

Keywords: Acute kidney injury; Cohort study; Hepatocellular carcinoma; Nationwide population-based; Transarterial chemoembolisation.