대한영상의학회지 (Journal of the Korean Society of Radiology)

  • 제83권2호
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  • Pages.317-330
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  • 2022
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  • 1738-2637(pISSN)
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  • 2951-0805(eISSN)
대한영상의학회 (The Korean Society of Radiology)
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신장 종양 고주파 절제술 이후 신장 기능 저하의 위험요소

Risk Factors for Renal Function Impairment Following Radiofrequency Ablation of Renal Tumors

  • 박일철 (동아대학교 의과대학 영상의학교실) ;
  • 윤성국 (동아대학교 의과대학 영상의학교실) ;
  • 김동원 (동아대학교 의과대학 영상의학교실)
  • Il Cheol Park (Department of Radiology, Dong-A University College of Medicine) ;
  • Seong Kuk Yoon (Department of Radiology, Dong-A University College of Medicine) ;
  • Dong Won Kim (Department of Radiology, Dong-A University College of Medicine)
  • 투고 : 2021.04.30
  • 심사 : 2021.06.29
  • 발행 : 2022.03.01
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초록

목적 본 연구는 신장종양 환자에서 시행한 고주파절제술 이후 신장 기능에 영향을 미치는 다양한 요소들에 대한 평가를 통해서 이들의 상관관계와 임상적 가치를 평가하기 위한 것이다. 대상과 방법 2010년 1월부터 2018년 12월까지 본원에서 ultrasonography, CT 유도하에 고주파절제술을 시행 받은 91명을 대상으로 선정하였다. 신기능을 평가하는 방법으로 시술 직전과 시술 이후 혈청 크레아티닌, 사구체 여과율을 측정하였다. 시술 전과 비교하여 혈청 크레아티닌 수치가 0.3 mg/dL 이상 증가하는 것을 유의미한 것으로 정하고, 이에 근거하여 두 그룹으로 분류하였다. 신장 기능 손상에 영향을 미치는 요소를 평가하기 위해서 다변수 로지스틱 회귀분석을 이용해서 그룹 간에 비교를 시행하였다. 결과 단일 신장, 3단계 이상의 만성 콩팥병, 요관 손상은 신장 기능 손상에서 통계적으로 유의한 의미가 있었다. 성별, 연령, 다른 암, 종양 크기, 위치, 성장 형태, 집합계와의 근접성 등은 통계적으로 유의하지 않았다. 신장 기능 수치의 시간에 따른 변화는 단일 신장, 3단계 이상의 만성 콩팥병, 요관 손상 유무에 따라서 통계적으로 유의하게 달랐다. 결론 고주파절제술 시행 전의 의학적 상태 중 단일 신장, 3단계 이상의 만성 콩팥병, 시술 이후 발생한 합병증 중 요관 손상은 시술 이후 발생하는 신장 기능 손상의 위험요소로 생각할 수 있다.

Purpose To evaluate the various factors that affect renal function following percutaneous radiofrequency ablation (RFA) therapy in patients with renal tumors. Materials and Methods Between 2010 and 2018, 91 patients diagnosed with renal tumors using ultrasonography and CT-guided RFA were enrolled. We retrospectively investigated the serum creatinine (SCr) level and estimated glomerular filtration rates immediately prior to RFA and during post-treatment follow-up. The patients were divided into two groups based on the degree of change in SCr level (0.3 mg/dL). Group comparisons were performed using univariable and multivariable logistic regression analyses to determine the factors impacting renal function. Results Impaired renal function was associated with solitary kidney, chronic kidney disease (CKD) over stage 3, and pyeloureteral injury. Sex, age, other cancers, tumor size, location, growth pattern, and proximity to the collecting system were not significantly associated with impaired renal function. There was a difference in the overall change over time between the association with and without solitary kidney, CKD stage 3, and pyeloureteral injury. Conclusion Among the medical conditions present prior to RFA, solitary kidney and CKD over stage 3 could be considered as risk factors for impaired renal function. Post-procedural pyeloureteral injury can also be considered a risk factor.

키워드

과제정보

This work was supported by the Dong-A University research fund.

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