405 THE CLINICAL CHARACTERISTICS OF ACUTE KIDNEY INJURY AFTER TRANSARTERIAL CHEMOEMBOLIZATION IN PATIENTS WITH HEPATOCELLULAR CARCINOMA

The purpose of this study was to investigate the effect of acute kidney injury (AKI) on the prognosis of patients with hepatocellular carcinoma (HCC) undergoing transarterial chemoembolization (TACE). A total of 347 HCC patients with Child-Pugh class A and pre-TACE serum creatinine (SCr) ≤1.5 mg/dL undergoing TACE as an initial therapy 2000–2014 were analyzed. Overall survival with related risk factors including AKI was investigated. We assessed AKI based on the International Club of Ascites (ICA)-AKI criteria. The mean age was 60.9 years. Of 347 patients, death was observed in 109 patients (31.4%). The mean SCr levels at pre-TACE, one day, two months, and four months after TACE were 0.9, 0.9, 0.9, and 1.1 mg/dL, respectively. The AKI within four months after TACE developed in 37 patients (11%). The AKI stages were non-AKI in 310 (89%), stage 1 in 10 (3%), stage 2 in 10 (3%), and stage 3 in 17 patients (5%). Multivariable analysis showed that the risk factors for overall survival were serum albumin ≤3.5 g/dL (hazard ratio [HR] 1.58, p = 0.027), BCLC stage B (HR 2.07, p = 0.008), BCLC stage C (HR 3.96, p<0.001), bilobar tumor location (HR 1.66, p = 0.022), AKI stage 1 (HR 6.09, p<0.001), AKI stage 2 (HR 8.51, p<0.001), and AKI stage 3 (HR 17.64, p<0.001). AKI is a crucial prognostic factor for overall survival in HCC patients undergoing TACE. The assessment of AKI based on the ICA-AKI criteria can facilitate evaluation of the prognosis of HCC patients undergoing TACE.

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Acute Kidney Injury after Transarterial Chemoembolization for Hepatocellular Carcinoma: A Retrospective Analysis

Blood Purification ◽

10.1159/000157322 ◽

2008 ◽

Vol 26 (5) ◽

pp. 454-459 ◽

Cited By ~ 12

Author(s):

Jongha Park ◽

Hyun Chul Chung ◽

Jong Soo Lee ◽

Byeong Man Lee ◽

Dong Min Kim ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Acute Kidney Injury ◽

Retrospective Analysis ◽

Transarterial Chemoembolization ◽

Kidney Injury

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Clinical characteristics and prognosis of postpartum acute kidney injury

Journal of International Medical Research ◽

10.1177/0300060520988388 ◽

2021 ◽

Vol 49 (2) ◽

pp. 030006052098838

Author(s):

Hong Shu ◽

Fang Nie

Keyword(s):

Acute Kidney Injury ◽

Clinical Characteristics ◽

Survival Rates ◽

Kidney Injury ◽

Renal Recovery ◽

Replacement Treatment ◽

Elevated Liver Enzymes ◽

Recovery Times ◽

Low Platelet Count ◽

Lost To Follow Up

Objective To investigate the clinical characteristics and prognoses of patients with postpartum acute kidney injury (PPAKI). Methods We retrospectively reviewed the clinical presentations, laboratory examinations, treatments, and outcomes of patients with PPAKI admitted to our hospital from January 2013 to December 2017. We then analyzed the clinical characteristics and prognoses of the mothers and their infants. Results Of 37 patients diagnosed with PPAKI, 26 (70.3%) received treatment in the intensive care unit, mainly for hemolysis, elevated liver enzymes, low platelet count (HELLP) syndrome (28/37, 75.7%), pre-eclampsia (26/37, 70.3%), and postpartum hemorrhage (22/37, 59.5%). Twenty patients required renal replacement treatment (RRT), but renal recovery times were similar in the RRT and non-RRT groups. Renal function recovered completely in 30 patients (81.1%) and partially in one patient (2.7%), and was not re-examined in two patients (5.4%). Three patients (8.1%) were lost to follow-up. Only one patient (2.7%) remained dialysis-dependent, and no maternal deaths occurred. The preterm birth, low birth weight, and infant survival rates were 70.7% (29/41), 68.3% (28/41), and 78.0% (32/41), respectively. Conclusion RRT does not reduce renal recovery time compared with non-RRT. Overall, the prognoses of both mothers and their fetuses are good following treatment for PPAKI.

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Clinical characteristics and outcomes of patients with acute kidney injury: A single-center study

Saudi Journal of Kidney Diseases and Transplantation ◽

10.4103/1319-2442.113903 ◽

2013 ◽

Vol 24 (4) ◽

pp. 813

Author(s):

Nadeeka Rathnamalala

Keyword(s):

Acute Kidney Injury ◽

Clinical Characteristics ◽

Kidney Injury ◽

Single Center ◽

Single Center Study ◽

Center Study

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Clinical characteristics and mortality risk prediction in children with acute kidney injury

Nigerian Medical Journal ◽

10.4103/0300-1652.170381 ◽

2015 ◽

Vol 56 (5) ◽

pp. 327 ◽

Cited By ~ 2

Author(s):

Alireza Teimouri ◽

Simin Sadeghi-Bojd ◽

NoorMohammad Noori ◽

Mehdi Mohammadi

Keyword(s):

Acute Kidney Injury ◽

Risk Prediction ◽

Mortality Risk ◽

Clinical Characteristics ◽

Kidney Injury

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Are Blacks at Higher Risk for Vancomycin-Related Acute Kidney Injury?

Journal of Pharmacy Practice ◽

10.1177/0897190018800093 ◽

2019 ◽

Vol 33 (5) ◽

pp. 592-597 ◽

Cited By ~ 1

Author(s):

Mamta Sharma ◽

Kaylin Braekevelt ◽

Pramodini Kale-Pradhan ◽

Susan Szpunar ◽

Riad Khatib

Keyword(s):

Acute Kidney Injury ◽

Clinical Characteristics ◽

Trough Level ◽

Kidney Injury ◽

Comorbid Conditions ◽

Black Race ◽

Source Of Infection ◽

Vancomycin Trough ◽

Nephrotoxic Drugs ◽

Trough Levels

Background: Black individuals have a higher lifetime risk of acute kidney injury (AKI) and chronic kidney disease than whites. Vancomycin has a potential for nephrotoxicity. The objective of this study was to determine whether the incidence of AKI among patients being treated with vancomycin differs by race. Methods: Retrospective study of adult (3 ≥18 years) inpatients who were on vancomycin for 348 hours between January 2012 and December 2014. Data on demographics, comorbid conditions, clinical characteristics, vancomycin dose, duration, and nephrotoxic drugs were collected. Patients with a creatinine clearance <30 mL/min or undergoing dialysis were excluded. Results: We identified 1130 patients during the study period; 48.1% (544) were black. The overall incidence of AKI was 8.2% (10.1% blacks, 6.5% whites; P = .03). Independent predictors of AKI included black race ( P = .011); higher Charlson score ( P = .006); higher body mass index (BMI; P = .002); higher vancomycin trough level ( P < .0001); and sepsis/systemic inflammatory response syndrome (<.0001), pneumonia ( P = .001) or gastrointestinal/genitourinary ( P = .025) as the source of infection. Conclusion: The incidence of vancomycin-related AKI was higher in blacks, independent of other risk factors. Based on our study, vancomycin trough levels and renal function need to be closely monitored in blacks.

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Clinical Characteristics of Transarterial Chemoembolization in Treatment of Primary Hepatocellular Carcinoma Complicated With Respiratory Distress Syndrome

Technology in Cancer Research & Treatment ◽

10.1177/1533033820970673 ◽

2020 ◽

Vol 19 ◽

pp. 153303382097067

Author(s):

Ji-Yin Ruan ◽

Jia-Tian Lin ◽

Yu Xiong ◽

Zai-Zhong Chen ◽

Jun-Hui Chen ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Hormone Therapy ◽

Transarterial Chemoembolization ◽

Clinical Characteristics ◽

Pathogenic Bacteria ◽

Distress Syndrome ◽

Lateral Lobe ◽

Primary Hepatocellular Carcinoma

Objective: The present study aims to analyze the clinical characteristics and etiology of transarterial chemoembolization (TACE) in the treatment of hepatocellular carcinoma (HCC) complicated with acute respiratory distress syndrome (ARDS), in order to improve the early diagnosis rate and cure rate. Methods: A total of 816 patients with primary HCC received 2,200 TACE treatments from January 2014 to May 2018. Among these patients, 6 patients developed ARDS after TACE. The clinical data, lesion characteristics, laboratory tests, treatment process and prognosis of 6 patients were retrospectively analyzed. Results: The longest lesion diameter ranged within 5.0-10.2 cm (mean: 6.6 cm) in the 6 patients with primary HCC. Among these patients, 4 patients had lesions mainly located in the left lateral lobe of the liver, while 5 patients had no hepatic arteriovenous fistula detected before TACE. Nedaplatin, epirubicin and iodinated oil suspension chemoembolization were used in all 6 patients during TACE, and all of them experienced ARDS symptoms within 24-48 hours after TACE. However, no clear pathogenic bacteria were incubated in the sputum culture after the onset of the disease. Diffused exudative changes of both lungs were found in the chest X-ray, and the oxygenation index (PaO2/FiO2) was within 100-300 mmHg. The symptoms of 6 patients improved after 3-6 days of hormone therapy. Conclusion: In this study, we found that although the incidence of ARDS after TACE was low in the treatment for HCC, the symptoms after onset were serious, and the early hormone therapy may be beneficial to improve the prognosis and reduce mortality. Further research with larger samples is still needed to confirm the pathogenesis of ARDS after TACE in the treatment for HCC.

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