title: [Incidence and risk factors of acute renal failure after transcatheter arterial chemoembolization for hepatocellular carcinoma].
abstract: OBJECTIVE
  Transcatheter arterial chemoembolization (TACE) is a major modality in the treatment of unresectable hepatocellular carcinoma. Acute renal failure (ARF) may occur after TACE because of underlying liver cirrhosis and the presence of radiocontrast agent. However, the data available regarding this complication are variable and limited. The aim of this study was to determine the incidence and associated risk factors of ARF after TACE.
  
  
  METHODS
  From January 2001 to December 2004, a total of 632 procedures were performed in 377 patients. Of these, the cases with high creatinine levels (> or = 2 mg/dL) before TACE and with incomplete medical records were excluded, which resulted in 463 procedures in 319 patients (256 males and 63 females; age 58.7+/-9.9 years, mean+/-SD) being examined for this study. Various clinical and radiological data before and after the procedure were reviewed retrospectively.
  
  
  RESULTS
  ARF occurred following 15 (3.2%) of the 463 procedures within 7 days of TACE. Univariate analysis revealed that serum albumin levels (P=0.025), Model for End-Stage Liver Disease score (P=0.001), the distribution of Child-Pugh class (P=0.027), and the proportions of patients with ascites (P<0.001), using diuretics (P=0.010), and with a serum creatinine level > or = 1.5 mg/dL (P=0.023) differed significantly between patients with or without ARF after TACE. In multivariate analysis, the presence of ascites (P=0.005; odds ratio, 5.297) and serum creatinine level > or = 1.5 mg/dL (P=0.007; odds ratio, 7.358) were independently associated with the development of ARF.
  
  
  CONCLUSIONS
  The incidence of ARF after TACE was 3.2%, and the presence of ascites and an abnormal baseline serum creatinine level were the risk factors for ARF.
authors.affiliation: Department of Internal Medicine, Keimyung University College of Medicine, Daegu, Korea.
authors.forename: Byoung Kuk
authors.initials: BK
authors.lastname: Jang
authors.forename: Seung Hyun
authors.initials: SH
authors.lastname: Lee
authors.forename: Woo Jin
authors.initials: WJ
authors.lastname: Chung
authors.forename: Kyung Sik
authors.initials: KS
authors.lastname: Park
authors.forename: Kwang Bum
authors.initials: KB
authors.lastname: Cho
authors.forename: Jae Seok
authors.initials: JS
authors.lastname: Hwang
authors.forename: Young Hwan
authors.initials: YH
authors.lastname: Kim
authors.forename: Jin Soo
authors.initials: JS
authors.lastname: Choi
authors.forename: Jung Hyeok
authors.initials: JH
authors.lastname: Kwon
mesh_terms: D058186:Acute Kidney Injury / Q000453:epidemiology* / Q000209:etiology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects* / Q000401:mortality; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D015994:Incidence; D008113:Liver Neoplasms / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011859:Radiography; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D016019:Survival Analysis
chemical_list: D003404:Creatinine