Effect of transcatheter arterial chemoembolization on kidney hemodynamics and function in patients with cirrhosis and hepatocellular carcinoma

Background/Aims: Transcatheter arterial chemoembolization (TACE) may have d eleterious effect on the kidney in patients with cirrhosis and hepatocellul ar carcinoma. The aim of the study was to test this hypothesis. Methods: Twenty-four patients with cirrhosis and hepatocellular carcinomas were included. They consisted of 16 patients undergoing a single TACE and e ight patients undergoing diagnostic angiography, Doppler ultrasonography wa s used to measure hepatic artery pulsatility index (HA-PI) and renal artery pulsatility index (RA-PI) before and 1 day and 10 days after the procedure . Similarly, kidney function was assessed by measuring creatinine clearance . In addition, plasma renin activity, noradrenaline, and endothelin-1 were also measured. Results: In patients receiving diagnostic angiography, no significant chang es in HA-PI were observed after the procedure. In contrast, HA-PI increased significantly 1 day after the procedure (19%, p<0.01) in patients undergoi ng TACE, although it returned to baseline value 10 days after the procedure . In patients undergoing diagnostic angiography, no significant changes; in RA-PI were observed after the procedure, Similarly, no detectable changes in RA-PI mere noted in patients undergoing TACE, A transient small reductio n in creatinine clearance was noted after the procedure in patients undergo ing diagnostic angiography (-12%, p<0.05) and in those undergoing TACE (-11 %, p<0.05). However, the effect was similar in the two groups (two-way ANOV A, p=0.72). No significant changes in plasma renin activity noradrenaline, and endothelin-1 mere observed after either diagnostic angiography or TACE. Conclusions: These results suggest that TACK per se has no deleterious effe ct on the kidney hemodynamics and function in patients with cirrhosis and, hepatocellular carcinoma.