{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T18:11:02Z","timestamp":1790187062147,"version":"4.1.0"},"reference-count":32,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2020,12,14]],"date-time":"2020-12-14T00:00:00Z","timestamp":1607904000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>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) \u22641.5 mg\/dL undergoing TACE as an initial therapy 2000\u20132014 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 \u22643.5 g\/dL (hazard ratio [HR] 1.58, <jats:italic>p<\/jats:italic> = 0.027), BCLC stage B (HR 2.07, <jats:italic>p<\/jats:italic> = 0.008), BCLC stage C (HR 3.96, <jats:italic>p<\/jats:italic>&lt;0.001), bilobar tumor location (HR 1.66, <jats:italic>p<\/jats:italic> = 0.022), AKI stage 1 (HR 6.09, <jats:italic>p<\/jats:italic>&lt;0.001), AKI stage 2 (HR 8.51, <jats:italic>p<\/jats:italic>&lt;0.001), and AKI stage 3 (HR 17.64, <jats:italic>p<\/jats:italic>&lt;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.<\/jats:p>","DOI":"10.1371\/journal.pone.0243780","type":"journal-article","created":{"date-parts":[[2020,12,14]],"date-time":"2020-12-14T18:28:13Z","timestamp":1607970493000},"page":"e0243780","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":6,"title":["Effect of acute kidney injury on the patients with hepatocellular carcinoma undergoing transarterial chemoembolization"],"prefix":"10.1371","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3284-2715","authenticated-orcid":true,"given":"Won","family":"Sohn","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheol Bae","family":"Ham","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nam Hee","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4121-6329","authenticated-orcid":true,"given":"Hong Joo","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong Kyun","family":"Cho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Woo Kyu","family":"Jeon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Byung Ik","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2020,12,14]]},"reference":[{"issue":"6","key":"pone.0243780.ref001","doi-asserted-by":"crossref","first-page":"394","DOI":"10.3322\/caac.21492","article-title":"Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"68","author":"F Bray","year":"2018","journal-title":"CA Cancer J Clin"},{"issue":"1","key":"pone.0243780.ref002","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1016\/j.jhep.2018.03.019","article-title":"EASL Clinical Practice Guidelines: Management of hepatocellular carcinoma","volume":"69","author":"European Association for the Study of the Liver","year":"2018","journal-title":"J Hepatol"},{"issue":"1","key":"pone.0243780.ref003","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1002\/hep.29086","article-title":"AASLD guidelines for the treatment of hepatocellular carcinoma","volume":"67","author":"JK Heimbach","year":"2018","journal-title":"Hepatology"},{"key":"pone.0243780.ref004","doi-asserted-by":"crossref","first-page":"16018","DOI":"10.1038\/nrdp.2016.18","article-title":"Hepatocellular carcinoma","volume":"2","author":"JM Llovet","year":"2016","journal-title":"Nat Rev Dis Primers"},{"issue":"6","key":"pone.0243780.ref005","doi-asserted-by":"crossref","first-page":"2064","DOI":"10.1002\/hep.22605","article-title":"Acute kidney injury in cirrhosis","volume":"48","author":"G Garcia-Tsao","year":"2008","journal-title":"Hepatology"},{"issue":"3","key":"pone.0243780.ref006","doi-asserted-by":"crossref","first-page":"195","DOI":"10.14218\/JCTH.2015.00015","article-title":"Acute Kidney Injury in Patients with Cirrhosis","volume":"3","author":"KB Russ","year":"2015","journal-title":"J Clin Transl Hepatol"},{"issue":"2","key":"pone.0243780.ref007","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1093\/gastro\/gox009","article-title":"Renal dysfunction in cirrhosis: acute kidney injury and the hepatorenal syndrome","volume":"5","author":"T Bucsics","year":"2017","journal-title":"Gastroenterol Rep (Oxf)"},{"issue":"9","key":"pone.0243780.ref008","first-page":"1310","article-title":"Diagnosis, prevention and treatment of hepatorenal syndrome in cirrhosis","volume":"56","author":"F Salerno","year":"2007","journal-title":"Gut"},{"issue":"4","key":"pone.0243780.ref009","doi-asserted-by":"crossref","first-page":"415","DOI":"10.3350\/cmh.2016.0056","article-title":"Acute kidney injury in liver cirrhosis: new definition and application","volume":"22","author":"F Wong","year":"2016","journal-title":"Clin Mol Hepatol"},{"issue":"4","key":"pone.0243780.ref010","doi-asserted-by":"crossref","first-page":"968","DOI":"10.1016\/j.jhep.2014.12.029","article-title":"Diagnosis and management of acute kidney injury in patients with cirrhosis: revised consensus recommendations of the International Club of Ascites","volume":"62","author":"P Angeli","year":"2015","journal-title":"J Hepatol"},{"issue":"12","key":"pone.0243780.ref011","doi-asserted-by":"crossref","first-page":"1590","DOI":"10.1080\/00365521.2018.1545423","article-title":"Evaluation of the criteria of hepatorenal syndrome type of acute kidney injury in patients with cirrhosis admitted to ICU","volume":"53","author":"J Xiong","year":"2018","journal-title":"Scand J Gastroenterol"},{"issue":"9319","key":"pone.0243780.ref012","doi-asserted-by":"crossref","first-page":"1734","DOI":"10.1016\/S0140-6736(02)08649-X","article-title":"Arterial embolisation or chemoembolisation versus symptomatic treatment in patients with unresectable hepatocellular carcinoma: a randomised controlled trial","volume":"359","author":"JM Llovet","year":"2002","journal-title":"Lancet"},{"issue":"5","key":"pone.0243780.ref013","doi-asserted-by":"crossref","first-page":"1164","DOI":"10.1053\/jhep.2002.33156","article-title":"Randomized controlled trial of transarterial lipiodol chemoembolization for unresectable hepatocellular carcinoma","volume":"35","author":"CM Lo","year":"2002","journal-title":"Hepatology"},{"issue":"11","key":"pone.0243780.ref014","doi-asserted-by":"crossref","first-page":"4482","DOI":"10.1007\/s00330-017-4893-x","article-title":"Risk of acute kidney injury after transarterial chemoembolisation in hepatocellular carcinoma patients: A nationwide population-based cohort study","volume":"27","author":"BC Lee","year":"2017","journal-title":"Eur Radiol"},{"issue":"7","key":"pone.0243780.ref015","doi-asserted-by":"crossref","first-page":"1397","DOI":"10.1111\/jgh.14083","article-title":"Impact of clinically evident portal hypertension on clinical outcome of patients with hepatocellular carcinoma treated by transarterial chemoembolization","volume":"33","author":"NH Kim","year":"2018","journal-title":"J Gastroenterol Hepatol"},{"issue":"5","key":"pone.0243780.ref016","doi-asserted-by":"crossref","first-page":"1187","DOI":"10.1016\/j.jhep.2015.02.010","article-title":"Transarterial chemoembolization: modalities, indication, and patient selection","volume":"62","author":"W Sieghart","year":"2015","journal-title":"J Hepatol"},{"issue":"9","key":"pone.0243780.ref017","doi-asserted-by":"crossref","first-page":"999","DOI":"10.1111\/j.1365-2036.2004.01936.x","article-title":"Acute renal failure after transarterial chemoembolization for hepatocellular carcinoma: a retrospective study of the incidence, risk factors, clinical course and long-term outcome","volume":"19","author":"TI Huo","year":"2004","journal-title":"Aliment Pharmacol Ther"},{"issue":"Suppl 2","key":"pone.0243780.ref018","first-page":"e3","article-title":"Incidence, risk factors, and prognosis of acute kidney injury following transarterial chemoembolization in patients with hepatocellular carcinoma: a prospective cohort study","volume":"51","author":"JF Hao","year":"2015","journal-title":"Indian J Cancer"},{"issue":"5","key":"pone.0243780.ref019","first-page":"2579","article-title":"Prognostic factors for acute kidney injury following transarterial chemoembolization in patients with hepatocellular carcinoma","volume":"7","author":"C Zhou","year":"2014","journal-title":"Int J Clin Exp Pathol"},{"issue":"1","key":"pone.0243780.ref020","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1111\/j.1478-3231.2009.02128.x","article-title":"Renal failure in patients with hepatocellular carcinoma and ascites undergoing transarterial chemoembolization","volume":"30","author":"CY Hsu","year":"2010","journal-title":"Liver Int"},{"issue":"22","key":"pone.0243780.ref021","doi-asserted-by":"crossref","first-page":"2146","DOI":"10.1056\/NEJMra1805256","article-title":"Contrast-Associated Acute Kidney Injury","volume":"380","author":"R Mehran","year":"2019","journal-title":"N Engl J Med"},{"issue":"3","key":"pone.0243780.ref022","doi-asserted-by":"crossref","first-page":"e21","DOI":"10.1097\/MCG.0b013e31822e8e12","article-title":"Acute kidney injury network criteria as a predictor of hospital mortality in cirrhotic patients with ascites","volume":"46","author":"JR de Carvalho","year":"2012","journal-title":"J Clin Gastroenterol"},{"key":"pone.0243780.ref023","article-title":"Changing epidemiology and outcomes of acute kidney injury in hospitalized patients with cirrhosis\u2014a US population-based study","author":"AP Desai","year":"2020","journal-title":"J Hepatol"},{"issue":"1","key":"pone.0243780.ref024","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1093\/jjco\/hyz129","article-title":"Acute kidney injury after platinum-based transcatheter arterial chemoembolization and transarterial infusion chemotherapy in patients with hepatocellular carcinoma","volume":"50","author":"M Hayashi","year":"2020","journal-title":"Jpn J Clin Oncol"},{"issue":"4","key":"pone.0243780.ref025","doi-asserted-by":"crossref","first-page":"R204","DOI":"10.1186\/cc2872","article-title":"Acute Dialysis Quality Initiative w. Acute renal failure\u2014definition, outcome measures, animal models, fluid therapy and information technology needs: the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group","volume":"8","author":"R Bellomo","year":"2004","journal-title":"Crit Care"},{"issue":"3","key":"pone.0243780.ref026","doi-asserted-by":"crossref","first-page":"R73","DOI":"10.1186\/cc4915","article-title":"RIFLE criteria for acute kidney injury are associated with hospital mortality in critically ill patients: a cohort analysis","volume":"10","author":"EA Hoste","year":"2006","journal-title":"Crit Care"},{"issue":"2","key":"pone.0243780.ref027","doi-asserted-by":"crossref","first-page":"R31","DOI":"10.1186\/cc5713","article-title":"Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury","volume":"11","author":"RL Mehta","year":"2007","journal-title":"Crit Care"},{"issue":"5","key":"pone.0243780.ref028","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1053\/j.ajkd.2013.02.349","article-title":"KDOQI US commentary on the 2012 KDIGO clinical practice guideline for acute kidney injury","volume":"61","author":"PM Palevsky","year":"2013","journal-title":"Am J Kidney Dis"},{"issue":"2","key":"pone.0243780.ref029","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1111\/liv.13515","article-title":"Incidence, predictive factors and impacts of acute kidney injury in cirrhotic patients hospitalized for cellulitis","volume":"38","author":"A Garcia Garcia de Paredes","year":"2018","journal-title":"Liver Int"},{"issue":"11","key":"pone.0243780.ref030","doi-asserted-by":"crossref","first-page":"1859","DOI":"10.1111\/jgh.13777","article-title":"Acute kidney injury predicts mortality in cirrhotic patients with gastric variceal bleeding","volume":"32","author":"YC Hsieh","year":"2017","journal-title":"J Gastroenterol Hepatol"},{"issue":"5","key":"pone.0243780.ref031","doi-asserted-by":"crossref","first-page":"870","DOI":"10.1111\/jgh.14871","article-title":"Effect of acute kidney injury on long-term outcomes of spontaneous bacterial peritonitis in cirrhotic patients using the International Club of Ascites-acute kidney injury criteria","volume":"35","author":"W Sohn","year":"2020","journal-title":"J Gastroenterol Hepatol"},{"issue":"10212","key":"pone.0243780.ref032","doi-asserted-by":"crossref","first-page":"1949","DOI":"10.1016\/S0140-6736(19)32563-2","article-title":"Acute kidney injury","volume":"394","author":"C Ronco","year":"2019","journal-title":"Lancet"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0243780","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,12,14]],"date-time":"2020-12-14T18:28:32Z","timestamp":1607970512000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0243780"}},"subtitle":[],"editor":[{"given":"Do Young","family":"Kim","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2020,12,14]]},"references-count":32,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2020,12,14]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0243780","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,12,14]]}}}