Hepatocellular carcinoma in patients with chronic kidney disease

Table 1 Baseline characteristics of patients with hepatocellular carcinoma, stratified according to the stage of chronic kidney disease n (%)

Variable	Total (n = 440)	Stages 1 and 2 (n = 132)	Stage 3 (n = 263)	Stages 4 and 5 (n = 45)	P value
eGFR1	53.7 ± 27.1	73.5 ± 13.5	50.0 ± 26.4	17.6 ± 8.7	0.000
Age1 (yr)	60.6 ± 11.9	54.4 ± 12.3	63.1 ± 10.5	64.0 ± 11.7	0.000
Male	329 (74.8)	115 (87.1)	182 (69.2)	32 (71.1)	0.000
HBV carrier	271 (61.6)	97 (73.5)	152 (57.8)	22 (48.9)	0.002
HCV carrier	201 (45.7)	42 (31.8)	131 (49.8)	28 (62.2)	0.000
HBV and HCV carrier	62 (14.1)	15 (11.4)	39 (14.8)	8 (17.8)	0.488
Follow-up duration1 (mo)	37.6 ± 37.1	37.0 ± 37.6	40.7 ± 37.6	20.9 ± 27.4	0.013

¹Data are presented as mean ± SD. The P value represents comparison between patients with stages 4 and 5 and patients with stages 1 and 2. eGFR: Estimated glomerular filtration rate; HBV: Hepatitis B virus; HCV: Hepatitis C virus.

Table 2 Liver function tests of patients with hepatocellular carcinoma, stratified according to the stage of chronic kidney disease (mean ± SD)

Variable	Total (n = 440)	Stage 1 and 2 (n = 132)	Stage 3 (n = 263)	Stages 4 and 5 (n = 45)	P value
AFP (ng/mL)	6202.1 ± 83392.3	3564.6 ± 11906.0	8176.6 ± 106579.9	1866.3 ± 4866.0	0.911
AST (U/L )	84.8 ± 77.9	94.3 ± 76.1	77.4 ± 68.6	104.3 ± 126.5	0.495
ALT (U/L)	73.0 ± 90.4	79.4 ± 79.1	64.8 ± 49.2	103.0 ± 218.9	0.150
T-bilirubin (mg/dL)	1.8 ± 3.7	1.5 ± 1.6	1.8 ± 4.3	2.8 ± 4.4	0.198
ALP (U/L)	122.4 ± 92.1	124.0 ± 76.6	114.6 ± 79.7	164.5 ± 170.2	0.072
Albumin (g/dL )	3.5 ± 0.7	3.6 ± 0.6	3.5 ± 0.7	3.2 ± 0.7	0.001
Prolonged PT (s)	1.9 ± 4.3	1.4 ± 1.2	1.6 ± 2.1	5.1 ± 12.4	0.000
Platelet count (x 103/μL)	138.2 ± 90.7	163.7 ± 109.7	126.5 ± 80.1	131.4 ± 73.0	0.037

The P value represents comparison between patients with stages 4 and 5 and patients with stages 1 and 2. AFP: Alpha-fetoprotein; AST: Aspartate aminotransferase; ALT: Alanine aminotransferase; T-bilirubin: Total bilirubin; ALP: Alkaline phosphatase; PT: Prothrombin time.

Table 3 Liver cirrhosis classification, tumor staging, cause of mortality of patients with hepatocellular carcinoma stratified according to the stage of chronic kidney disease n (%)

Variable	Total (n = 440)	Stage 1 and 2 (n = 132)	Stage 3 (n = 263)	Stages 4 and 5 (n = 45)	P value
Liver cirrhosis classification(Child-Pugh score)					0.002
No	53 (12.0)	27 (20.5)	23 (8.7)	3 (6.7)
Class A	236 (53.6)	67 (50.8)	151 (57.4)	18 (40.0)
Class B	110 (25.0)	30 (22.7)	64 (24.3)	16 (35.6)
Class C	41 (9.3)	8 (6.1)	25 (9.5)	8 (17.8)
Tumor stage					0.001
Stage 1	213 (48.4)	60 (45.5)	133 (50.6)	20 (44.4)
Stage 2	113 (25.7)	27 (20.5)	76 (28.9)	10 (22.2)
Stage 3	84 (19.1)	40 (30.3)	36 (13.7)	8 (17.8)
Stage 4	30 (6.8)	5 (3.8)	18 (6.8)	7 (15.6)
Mortality	162 (36.9)	47 (35.6)	94 (35.9)	21 (46.7)
Cause of mortality					0.050
Liver failure	27 (6.1)	10 (7.6)	16 (6.1)	1 (2.2)
Tumor death	35 (8.0)	8 (6.1)	22 (8.4)	5 (11.1)
Gastrointestinal bleeding	27 (6.1)	11 (8.3)	16 (6.1)	0 (0)
Sepsis	69 (15.7)	18 (13.6)	36 (13.7)	15 (33.3)
Others	5 (1.1)	1 (0.8)	4 (1.5)	0 (0)

The P value represents comparison between patients with stages 4 and 5 and patients with stages 1 and 2.

Table 4 Cox regression analysis of mortality in patients with hepatocellular carcinoma and chronic kidney disease

Variable	Univariate analysis		Multivariate analysis
	Odds ratio (95%CI)	P value	Odds ratio (95%CI)	P value
Chronic kidney disease stage	2.237 (1.376-3.636)	0.001	1.988 (1.012-3.906)	0.046
Liver cirrhosis stage	4.566 (2.331-8.929)	0.000	3.571 (1.590-8.000)	0.002
Tumor stage	3.509 (1.789-6.849)	0.000	2.169 (0.997-4.717)	0.051
Albumin, each increase of 1 mg/dL	0.503 (0.399-0.633)	0.000	0.657 (0.491-0.878)	0.005
Prolonged prothrombin time, each increase of 1 s	1.062 (1.036-1.089)	0.000	0.977 (0.942-1.013)	0.215