Renal cortical retention on delayed CT and nephropathy following transcatheter arterial chemoembolisation

The aim of this study was to examine the relationship between renal cortical retention on delayed CT and contrast medium-associated and/or transarterial chemoembolisation (TACE)-associated nephropathy following TACE. The authors reviewed the findings on 180 treatments in 121 patients with normal serum creatinine levels who underwent TACE for liver tumours. Nephropathy was defined as an increase in the creatinine level of greater than 0.5 mg x dl(-1) (44 micromol x l(-1)) and greater than 25% on days 1, 3, 7 or 14 post TACE. Renal cortical retention was recognized when CT values for the renal cortex showed either mild renal cortical retention (CT value >50) or severe renal cortical retention (CT value >100). There was evidence of renal cortical retention in 81 (45%) cases and of nephropathy in 11 (6%) cases. Only 2% of patients without renal cortical retention showed nephropathy, whereas 11% of those with renal cortical retention showed nephropathy (p=0.02). Stepwise selection using a multivariate logistic regression model showed renal cortical retention and gender to be significant factors for nephropathy following TACE. In conclusion, renal cortical retention is a useful predicator for nephropathy following TACE. Delayed CT could be used not only for assessment of lipiodol retention but also for predicting nephropathy.