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Prognostic Value of PALBI in Patients With Hepatocellular Carcinoma and Concurrent Chronic Kidney Disease: A Nomogram

Jihye Lim1,2, Seok-Hwan Kim1,3, Myeong Jun Song1,3

  • 1The Catholic University Liver Research Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.

Hepatology Research : the Official Journal of the Japan Society of Hepatology
|April 22, 2026
PubMed

Insights

Prognosis for liver cancer (HCC) with kidney disease (CKD) is complex. The PALBI score and a new nomogram offer improved survival prediction for these patients.

Area of Science:

  • Hepatology
  • Nephrology
  • Oncology

Background:

  • Prognosis in hepatocellular carcinoma (HCC) is influenced by tumor burden, liver function, and comorbidities like chronic kidney disease (CKD).
  • Existing prognostic models have not been systematically evaluated for patients with both HCC and CKD.

Purpose of the Study:

  • To compare the predictive accuracy of established liver-specific prognostic models in patients with HCC and CKD.
  • To develop a novel nomogram for individualized survival prediction in this patient population.

Main Methods:

  • A nationwide multicenter cohort study included 1201 treatment-naive patients with newly diagnosed HCC and concurrent CKD.
  • Prognostic performance for overall survival was assessed using Child-Pugh, MELD, MELD-Na, MELD 3.0, ALBI, and PALBI scores.

Main Results:

  • The PALBI score demonstrated favorable discriminative ability for survival prediction at 3, 6, and 12 months (AUROC 0.871, 0.857, 0.833).
  • A nomogram integrating PALBI grade with clinical factors (age, AFP, CKD stage, BCLC stage, treatment) provided well-calibrated individualized survival estimates.

Conclusions:

  • The PALBI score offers comparable prognostic performance to other liver-specific models in HCC patients with CKD, utilizing objective laboratory parameters.
  • The developed nomogram serves as a practical tool for personalized risk stratification and treatment decisions in this complex patient group.
Abstract

Keywords:
carcinomahepatocellularkidney function testsliver function testsprognosisrisk assessment

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