Acute kidney injury after liver cancer ablation: Risk factors and perioperative management

doi:10.4240/wjgs.124030

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Publication Name

World Journal of Gastrointestinal Surgery

ISSN

1948-9366

Publisher of This Article

Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastrointest Surg. Nov 27, 2026; 18(11): 124030
Published online Nov 27, 2026. doi: 10.4240/wjgs.124030

Acute kidney injury after liver cancer ablation: Risk factors and perioperative management

Da-Wei Luo, Hai-Liang Du, Wan-Xing Duan

Da-Wei Luo, Department of Urology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, Shaanxi Province, China

Hai-Liang Du, Department of Anesthesiology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, Shaanxi Province, China

Wan-Xing Duan, Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi’an 710061, Shaanxi Province, China

Author contributions: Luo DW designed the research and wrote the first manuscript; Luo DW, Du HL and Duan WX contributed to conceiving the research and analyzing data; Duan WX conducted the analysis and provided guidance for the research; all authors reviewed and approved the final manuscript.

AI contribution statement: No AI tools were used in this study.

Institutional review board statement: This study was approved by the Ethic Committee of The First Affiliated Hospital of Xi’an Jiaotong University.

Informed consent statement: Informed consent was exempted due to the retrospective design of this study.

Conflict-of-interest statement: There is no conflict of interest.

Data sharing statement: No additional data are available.

Corresponding author: Wan-Xing Duan, Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta West Road, Yanta District, Xi’an 710061, Shaanxi Province, China. duanwan3@163.com

Received: July 10, 2026
Revised: August 19, 2026
Accepted: October 9, 2026
Published online: November 27, 2026
Processing time: 124 Days and 18.9 Hours

Abstract

BACKGROUND

Evidence regarding the risk factors for and clinical management of acute kidney injury (AKI) following liver cancer (LC) ablation remains limited.

AIM

To investigate the incidence and potential risk factors for AKI following LC ablation and explore relevant clinical preventive strategies.

METHODS

This retrospective study included 168 patients with LC who underwent ablation between May 2022 and February 2026. Patients were classified into AKI (n = 25) and non-AKI (n = 143) groups according to postoperative AKI occurrence. Baseline characteristics, tumor-related characteristics (laterality, TNM stage, tumor size, tumor number, and ablation type), and laboratory parameters were compared between groups. Univariate and multivariable logistic regression analyses were performed to identify factors associated with AKI after LC ablation.

RESULTS

Age, diabetes, TNM stage, tumor size, hemoglobin (Hb), uric acid (UA), and serum creatinine (SCr) differed significantly between groups. Univariate analysis identified older age, diabetes, larger tumor size, higher UA, and higher SCr levels as potential risk factors, while higher Hb was associated with a lower risk of AKI. Multivariate analysis identified Hb and SCr as independent factors associated with AKI, with higher Hb associated with a lower risk [odds ratio (OR): 0.908, 95% confidence interval (CI): 0.867-0.950, P < 0.001] and higher SCr associated with an increased risk (OR: 1.040, 95%CI: 1.004-1.078, P = 0.031).

CONCLUSION

Lower preoperative Hb and higher preoperative SCr levels may increase the risk of AKI after LC ablation. Preoperative anemia management and renal function assessment may help identify high-risk patients and guide individualized perioperative renal protection strategies.

Keywords: Liver cancer ablation; Acute kidney injury; Influencing factors; Clinical countermeasures

Core Tip: This retrospective study evaluated risk factors for acute kidney injury (AKI) after liver cancer (LC) ablation in 168 patients (AKI group, n = 25; non-AKI group, n = 143). Low preoperative hemoglobin and high creatinine levels were independently associated with increased AKI risk after LC ablation. Preoperative anemia management and careful renal function monitoring may help identify high-risk patients and guide perioperative renal protection.