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

Table 1 Baseline data, n (%)

Indicators	AKI group (n = 25)	Non-AKI group (n = 143)	χ2/t	P value
Sex			0.115	0.734
Male	20 (80.00)	110 (76.92)
Female	5 (20.00)	33 (23.08)
Age (years)	61.68 ± 8.91	56.62 ± 10.33	2.303	0.023
Body mass index (kg/m2)	23.74 ± 2.24	23.16 ± 2.41	1.121	0.264
Comorbid hypertension			3.127	0.077
No	12 (48.00)	95 (66.43)
Yes	13 (52.00)	48 (33.57)
Comorbid diabetes			5.655	0.017
No	14 (56.00)	112 (78.32)
Yes	11 (44.00)	31 (21.68)
Comorbid hyperlipidaemia			0.047	0.829
No	20 (80.00)	117 (81.82)
Yes	5 (20.00)	26 (18.18)
Smoking history			0.485	0.486
No	13 (52.00)	85 (59.44)
Yes	12 (48.00)	58 (40.56)
Drinking history			0.587	0.443
No	15 (60.00)	97 (67.83)
Yes	10 (40.00)	46 (32.17)

AKI: Acute kidney injury.

Table 2 Pathological files, n (%)

Indicators	AKI group (n = 25)	Non-AKI group (n = 143)	χ2/t	P value
Tumor site			0.206	0.650
Left	7 (28.00)	34 (23.78)
Right	18 (72.00)	109 (76.22)
TNM staging			4.005	0.045
I-II	17 (68.00)	121 (84.62)
III-IV	8 (32.00)	22 (15.38)
Tumor length (cm)	4.96 ± 2.40	3.98 ± 1.48	2.748	0.007
Tumor number			1.097	0.295
1	16 (64.00)	106 (74.13)
2-3	9 (36.00)	37 (25.87)
Ablation type			0.877	0.349
Radiofrequency ablation	7 (28.00)	54 (37.76)
Microwave ablation	18 (72.00)	89 (62.24)

AKI: Acute kidney injury.

Table 3 Laboratory indicators

Indicators	AKI group (n = 25)	Non-AKI group (n = 143)	t	P value
Hemoglobin (g/L)	114.20 ± 16.53	135.46 ± 13.79	6.897	< 0.001
Total bilirubin (μmol/L)	20.57 ± 4.57	19.85 ± 5.33	0.635	0.526
Serum albumin (g/L)	37.20 ± 3.92	36.11 ± 4.50	1.137	0.257
Urea nitrogen (mmol/L)	6.23 ± 1.84	5.84 ± 1.59	1.105	0.271
Uric acid (μmol/L)	383.36 ± 110.99	341.54 ± 82.64	2.210	0.029
Creatinine (μmol/L)	93.08 ± 24.15	77.73 ± 16.59	3.960	< 0.001
Serum sodium (mmol/L)	137.88 ± 4.03	138.47 ± 3.29	0.799	0.426
HDL-C (mmol/L)	1.03 ± 0.25	1.09 ± 0.31	0.916	0.361
LDL-C (mmol/L)	2.77 ± 0.53	2.66 ± 0.72	0.729	0.467

AKI: Acute kidney injury; HDL-C/LDL-C: High-/Low-density lipoprotein cholesterol.

Table 4 Assignment analysis

Indicators	Variable	Assignment
Age (years)	X1	< 60 = 0, ≥ 60 = 1
Comorbid diabetes	X2	No = 0, yes = 1
TNM staging	X3	I-II = 0, III-IV = 1
Tumor length (cm)	X4	< 5 cm = 0, ≥ 5 cm = 1
Hemoglobin (g/L)	X5	Continuous variable
Uric acid (μmol/L)	X6	Continuous variable
Creatinine (μmol/L)	X7	Continuous variable
Postoperative AKI	Y	No = 0, yes = 1

AKI: Acute kidney injury.

Table 5 Univariate analysis of acute kidney injury after hepatocellular carcinoma ablation

Indicators	B	SE	Wald	P value	OR	95%CI
Age (years)	1.016	0.451	5.085	0.024	2.762	1.142-6.679
Comorbid diabetes	1.043	0.451	5.349	0.021	2.839	1.172-6.873
TNM staging	0.951	0.487	3.807	0.051	2.588	0.996-6.728
Tumor length (cm)	0.326	0.125	6.859	0.009	1.386	1.086-1.769
Hemoglobin (g/L)	-0.105	0.021	24.717	< 0.001	0.900	0.864-0.938
Uric acid (μmol/L)	0.005	0.002	4.616	0.032	1.005	1.000-1.010
Creatinine (μmol/L)	0.044	0.013	12.228	< 0.001	1.045	1.020-1.072

OR: Odds ratio; CI: Confidence interval.

Table 6 Multivariate analysis of acute kidney injury after liver cancer ablation

Indicators	B	SE	Wald	P value	OR	95%CI
Age (years)	0.812	0.586	1.921	0.166	2.252	0.714-7.100
Comorbid diabetes	1.229	0.639	3.695	0.055	3.418	0.976-11.969
TNM staging	0.543	0.675	0.648	0.421	1.722	0.459-6.462
Tumor length (cm)	0.310	0.162	3.669	0.055	1.363	0.993-1.872
Hemoglobin (g/L)	-0.097	0.023	17.277	< 0.001	0.908	0.867-0.950
Uric acid (μmol/L)	0.001	0.003	0.064	0.801	1.001	0.994-1.008
Creatinine (μmol/L)	0.039	0.018	4.649	0.031	1.040	1.004–1.078

OR: Odds ratio; CI: Confidence interval.