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No previous study has evaluated the risks associated with transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma in patients on hemodialysis (HD) for end stage renal disease (ESRD), because invasive treatment is rarely performed for such patients. We used a nationwide database to investigate in-hospital mortality an...
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Context 1
... secondary end point was the occurrence of post-procedural complications during hospitalization. We used ICD-10 codes to identify the complications (Supplementary Table 1). ...Similar publications
Background/purpose:
The 2009 WHO guideline established warning signs (WS) to predict severe dengue (SD). However, their positive predictive value has been found to be low in the general adult population, but they might be higher in a different population. This study investigated the association between WS and SD in end stage renal disease (ESRD) p...
Citations
... Overall survival in the CKD group was significantly poor (10.9 ± 8.5 vs 23.5 ± 16.3 mo, P < 0.01). However, in another study conducted to clarify the benefits and risk of TACE in patients with HCC and CKD, 35 patients receiving TACE were enrolled and classified into a CKD group [including nondialysis CKD (NDCKD), n = 10 and ESRD, n = 9], and a non-CKD group (n = 16) [208]. The 2-and 5-year survival rates from initial diagnosis were comparable between the CKD and non-CKD groups. ...
... In the kidneys, glomerular podocytes express VEGF and glomerular endothelial cells express VEGF receptors [215,216]. Podocyte-specific deletion of a single VEGF allele caused proteinuria and capillary endotheliosis in rodents, and disrupted glomerular VEGF signaling was strongly implicated in the pathogenesis of human preeclampsia [208]. Sorafenib's mechanism of action clearly indicates its ability to induce significant adverse effects on the kidneys, including proteinuria, nephrotic syndrome, and preeclampsia-like syndrome [217,218]. ...
The population of patients with hepatocellular carcinoma (HCC) overlaps to a high degree with those for chronic kidney disease (CKD) and end-stage renal disease (ESRD). The degrees of renal dysfunction vary, from the various stages of CKD to dialysis-dependent ESRD, which often affects the prognosis and treatment choice of patients with HCC. In addition, renal dysfunction makes treatment more difficult and may negatively affect treatment outcomes. This study summarized the possible causes of the high comorbidity of HCC and renal dysfunction. The possible mechanisms of CKD causing HCC involve uremia itself, long-term dialysis status, immunosuppressive agents for postrenal transplant status, and miscellaneous factors such as hormone alterations and dysbiosis. The possible mechanisms of HCC affecting renal function include direct tumor invasion and hepatorenal syndrome. Finally, we categorized the risk factors that could lead to both HCC and CKD into four categories: Environmental toxins, viral hepatitis, metabolic syndrome, and vasoactive factors. Both CKD and ESRD have been reported to negatively affect HCC prognosis, but more research is warranted to confirm this. Furthermore, ESRD status itself ought not to prevent patients receiving aggressive treatments. This study then adopted the well-known Barcelona Clinic Liver Cancer guidelines as a framework to discuss the indicators for each stage of HCC treatment, treatment-related adverse renal effects, and concerns that are specific to patients with pre-existing renal dysfunction when undergoing aggressive treatments against CKD and ESRD. Such aggressive treatments include liver resection, simultaneous liver kidney transplantation, radiofrequency ablation, and transarterial chemoembolization. Finally, focusing on patients unable to receive active treatment, this study compiled information on the latest systemic pharmacological therapies, including targeted and immunotherapeutic drugs. Based on available clinical studies and Food and Drug Administration labels, this study details the drug indications, side effects, and dose adjustments for patients with renal dysfunction. It also provides a comprehensive review of information on HCC patients with renal dysfunction from disease onset to treatment.
... Overall survival in the CKD group was significantly poor (10.9 ± 8.5 vs 23.5 ± 16.3 mo, P < 0.01). However, in another study conducted to clarify the benefits and risk of TACE in patients with HCC and CKD, 35 patients receiving TACE were enrolled and classified into a CKD group [including nondialysis CKD (NDCKD), n = 10 and ESRD, n = 9], and a non-CKD group (n = 16) [208]. The 2-and 5-year survival rates from initial diagnosis were comparable between the CKD and non-CKD groups. ...
... In the kidneys, glomerular podocytes express VEGF and glomerular endothelial cells express VEGF receptors [215,216]. Podocyte-specific deletion of a single VEGF allele caused proteinuria and capillary endotheliosis in rodents, and disrupted glomerular VEGF signaling was strongly implicated in the pathogenesis of human preeclampsia [208]. Sorafenib's mechanism of action clearly indicates its ability to induce significant adverse effects on the kidneys, including proteinuria, nephrotic syndrome, and preeclampsia-like syndrome [217,218]. ...
The population of patients with hepatocellular carcinoma (HCC) overlaps to a high degree with those for chronic kidney disease (CKD) and end-stage renal disease (ESRD). The degrees of renal dysfunction vary, from the various stages of CKD to dialysis-dependent ESRD, which often affects the prognosis and treatment choice of patients with HCC. In addition, renal dysfunction makes treatment more difficult and may negatively affect treatment outcomes. This study summarized the possible causes of the high comorbidity of HCC and renal dysfunction. The possible mechanisms of CKD causing HCC involve uremia itself, long-term dialysis status, immunosuppressive agents for postrenal transplant status, and miscellaneous factors such as hormone alterations and dysbiosis. The possible mechanisms of HCC affecting renal function include direct tumor invasion and hepatorenal syndrome. Finally, we categorized the risk factors that could lead to both HCC and CKD into four categories: Environmental toxins, viral hepatitis, metabolic syndrome, and vasoactive factors. Both CKD and ESRD have been reported to negatively affect HCC prognosis, but more research is warranted to confirm this. Furthermore, ESRD status itself ought not to prevent patients receiving aggressive treatments. This study then adopted the well-known Barcelona Clinic Liver Cancer guidelines as a framework to discuss the indicators for each stage of HCC treatment, treatment-related adverse renal effects, and concerns that are specific to patients with pre-existing renal dysfunction when undergoing aggressive treatments against CKD and ESRD. Such aggressive treatments include liver resection, simultaneous liver kidney transplantation, radiofrequency ablation, and transarterial chemoembolization. Finally, focusing on patients unable to receive active treatment, this study compiled information on the latest systemic pharmacological therapies, including targeted and immunotherapeutic drugs. Based on available clinical studies and Food and Drug Administration labels, this study details the drug indications, side effects, and dose adjustments for patients with renal dysfunction. It also provides a comprehensive review of information on HCC patients with renal dysfunction from disease onset to treatment.
