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Zhou C.,The Anhui Provincial Hospital | Wang R.,Anhui Medical University | Ding Y.,The Anhui Provincial Hospital | Du D.,Anhui Medical University | And 4 more authors.
International Journal of Clinical and Experimental Pathology | Year: 2014

Purpose: Transarterial chemoembolization (TACE) is an effective treatment for patients with unresectable hepatocellular carcinoma (HCC). However, acute kidney injury (AKI) is a severe complication that commonly occurs in patients undergo TACE. In this study, we aim to investigate the incidence and risk factors associated with AKI in HCC patients received TACE treatment. Methods: This study enrolled 380 HCC patients who received a total of 453 TACE treatments. The incidence, clinical outcomes and risk factors of AKI were examined. Results: The incidence of post-TACE AKI was 9.05% (41/453). Of these, 3 patients (7.3%) progressed to chronic kidney failure while 7 patients (17.1%) died within 1 month of TACE. The Child-Pugh score (OR=3.784, 95% CI 1.899-7.542, p=0.000), pre-operative serum uric acid (OR=1.450, 95% CI 1.202-1.750, p=0.000), and proteinuria (OR=2.393, 95% CI 1.139-5.031, p=0.021) were independent risk factors for the development of post-TACE AKI. Conclusion: AKI is a common complication in HCC patients received TACE. The Child-Pugh score, preoperative serum uric acid and proteinuria may be used to predict the risk of post-TACE AKI in HCC patients undergo TACE.

Zhou C.,The Anhui Provincial Hospital | Hou C.,The Anhui Provincial Hospital | Cheng D.,The Anhui Provincial Hospital | Tang W.,The Anhui Provincial Hospital | Lv W.,The Anhui Provincial Hospital
International Journal of Clinical and Experimental Medicine | Year: 2015

Background: Child-Turcotte-Pugh (CTP) and the model for end-stage liver disease (MELD) scores have been used commonly to predict the survival in the patients with liver diseases underwent transjugular intrahepatic portosystemic shunt (TIPS). However, a debate has continued for years whether CTP could be replaced by MELD score. We performed a systematic meta-analytic review to compare the prediction capability of both scores in sur­vival among patients with TIPS. Methods: Retrospective cohort studies among patients with TIPS were published as of May 2013 were identified by systematically searching four electronic literature database, such as Ovid Medline, PubMed, EMBASE, and ISI Web of Science. The difference of standardized mean difference (SMD) of c-statistics for the predictive accuracy of 1-, 3-, 6-, and 12-month survival for both MELD and CP scores, defined as effect size (ES), was calculated for each individual study and then pooled across studies using standard meta-analyses with a random effects model. Publication bias was evaluated using funnel plots and Kendall’s rank correlation tests. Results: 174 researches articles or conference abstracts were searched and reviewed using the combination of relevant terms in the articles. Finally, 11 articles were defined as eligible studies to evaluate simultaneously the predictive accuracy of MELD and CTP scores. In the meta-analyses, MELD score was superior to CP score in predict­ing 3-month survival after TIPS (mean ES, 0.63; 95% confidence interval [CI], 0.13-1.14; P=0.01), but the predictive capability in 1-month, 6-month, and 12-month survival was not significant (1-month: mean ES, 0.79; 95% CI, -0.24-1.83; P=0.13; 6-month: mean ES, 0.46; 95% CI, -2.46-3.37; P=0.76; 12-month: mean ES, 0.36; 95% CI, -0.25-0.96; P=0.25). Conclusions: No enough evidence are confirmed so far that MELD score is better than CTP score to assess the overall prognosis after TIPS, especially long-term predictions, but 3-month predictive capability of MELD score significantly outperform CTP score. © 2015, E-Century Publishing Corporation. All rights reserved.

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