Does Chronic Kidney Disease Really Affect the Complications and Prognosis After Liver Resection for Hepatocellular Carcinoma? A Meta-Analysis

• Published in: Frontiers in surgery Vol. 9; p. 870946
• Main Authors: Liu, Xiao-Yu, Zhao, Zhi-Qiang, Cheng, Yu-Xi, Tao, Wei, Yuan, Chao, Zhang, Bin, Wang, Chun-Yi
• Format: Journal Article
• Language: English
• Published: Switzerland Frontiers Media S.A 06.04.2022
• Subjects: chronic kidney disease; complications; hepatocellular carcinoma; meta-analysis; overall survival; Surgery; meta-analysis; overall survival; chronic kidney disease; complications; hepatocellular carcinoma
• ISSN: 2296-875X; 2296-875X
• DOI: 10.3389/fsurg.2022.870946

The purpose of this meta-analysis was to analyze whether chronic kidney disease (CKD) affected the complications and prognosis after liver resection for hepatocellular carcinoma. The PubMed, Embase, and Cochrane Library databases were searched from inception to 22 February 2022 to find eligible studies. Complications, overall survival (OS), and disease-free survival (DFS) were collected, and this meta-analysis was performed with RevMan 5.3. A total of nine studies including 6,541 patients were included in this meta-analysis. After pooling all baseline information, the CKD group had a higher rate of Child-Pugh grade B than the Non-CKD group (OR = 1.58, 95% CI = 1.3 to 1.93, < 0.00001). As for surgery-related information, the CKD group had larger blood loss (MD = -404.79, 95% CI = -509.70 to -299.88, < 0.00001), and higher rate of blood transfusion (OR = 2.47, 95% CI = 1.85 to 3.3, < 0.00001). In terms of complications, the CKD group had a higher rate of overall complications (OR = 2.1, 95% CI = 1.57 to 2.81, < 0.00001) and a higher rate of ≥ grade III complications (OR = 2.04, 95% CI = 1.57 to 2.81, = 0.0002). The CKD group had poor OS compared with the non-CKD group (HR = 1.28, 95% CI = 1.1 to 1.49, = 0.001). However, in terms of DFS, no significant difference was found (HR = 1.11, 95% CI = 0.96 to 1.28, = 0.16). Preexisting CKD was associated with higher ratio of complications and poor OS.