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Predictive risk factors of acute kidney injury after cytoreductive surgery and cisplatin-based hyperthermic intra-peritoneal chemotherapy for ovarian peritoneal carcinomatosis
  1. Martina Aida Angeles1,
  2. François Quenet2,
  3. Pierre Vieille1,3,
  4. Laurence Gladieff4,
  5. Jean Ruiz5,
  6. Muriel Picard5,
  7. Federico Migliorelli6,
  8. Leonor Chaltiel7,
  9. Carlos Martínez-Gómez1,8,
  10. Alejandra Martinez1,8 and
  11. Gwénaël Ferron1,9
  1. 1 Department of Surgical Oncology, Institut Claudius Regaud – Institut Universitaire du Cancer de Toulouse (IUCT) – Oncopole, Toulouse, France
  2. 2 Department of Surgical Oncology, Institut du Cancer de Montpellier (ICM), Montpellier, France
  3. 3 Department of Gynecology, CHR, Perpignan, France
  4. 4 Department of Medical Oncology, Institut Claudius Regaud – Institut Universitaire du Cancer de Toulouse (IUCT) – Oncopole, Toulouse, France
  5. 5 Intensive Care Unit, Institut Claudius Regaud – Institut Universitaire du Cancer de Toulouse (IUCT) – Oncopole, Toulouse, France
  6. 6 Institute Clinic of Gynecology, Obstetrics and Neonatology, Hospital Clínic de Barcelona, Barcelona, Spain
  7. 7 Biostatistics Unit, Institut Claudius Regaud – Institut Universitaire du Cancer de Toulouse (IUCT) – Oncopole, Toulouse, France
  8. 8 INSERM CRCT 1, Toulouse, France
  9. 9 INSERM CRCT 19, Toulouse, France
  1. Correspondence to Gwénaël Ferron, Institut Claudius RegaudInstitut Universitaire du Cancer de Toulouse, Toulouse 31059, France; Ferron.Gwenael{at}iuct-oncopole.fr

Abstract

Objective The aim of our study was to assess the incidence and identify the predictive risk factors of acute kidney injury after cytoreductive surgery and cisplatin-based hyperthermic intra-peritoneal chemotherapy.

Methods This is a retrospective study from two centers evaluating patients with advanced or recurrent ovarian cancer who underwent cytoreductive surgery followed by cisplatin-based hyperthermic intra-peritoneal chemotherapy from January 2007 to December 2013. Patients were classified into two groups according to the occurrence of acute kidney injury, defined as a glomerular filtration rate at post-operative day 7 25% lower than at day 0. We also evaluated acute kidney injury following Risk, Injury, Failure, Lost and End-stage kidney function criteria. Univariate and multivariate analyses were conducted in order to assess the association between different variables and the occurrence of acute kidney injury.

Results Sixty-six patients were included: 29 (44%) underwent first-line treatment and 37 (56%) were treated for recurrent disease. The incidence of post-operative acute kidney injury was 48%. After multivariate analysis, hypertension (OR 18.6; 95% CI 1.9 to 182.3; p=0.012) and low intra-operative diuresis (OR 0.5; 95% CI 0.4 to 0.8; p=0.001) were associated with acute kidney injury.

Conclusion The incidence of acute kidney injury after cytoreductive surgery and cisplatin-based hyperthermic intra-peritoneal chemotherapy was high. Hypertension and low intra-operative diuresis were independent risk factors for this complication. Adequate peri-operative hydration, in order to maintain correct diuresis, could decrease the occurrence of acute kidney injury in patients undergoing cytoreductive surgery plus hyperthermic intra-peritoneal chemotherapy.

  • peritoneal carcinomatosis
  • ovarian cancer
  • hyperthermic intraperitoneal chemotherapy
  • cisplatin
  • RIFLE and nephrotoxicity

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Footnotes

  • Contributors MAA: Conceptualization, data curation, methodology, writing, original draft. FQ: Conceptualization, project administration, methodology writing, review. PV: Conceptualization, data curation, methodology, writing, original draft. LG: Conceptualization, project administration, methodology writing, review. JR: Conceptualization, project administration, methodology writing, review. MP: Conceptualization, project administration, methodology writing, review. FM: Conceptualization, data curation, methodology, writing, original draft. LC: Methodology, formal analysis. CM: Data curation, methodology, writing, original draft. AM: Conceptualization, project administration, methodology, writing, review. GF: Conceptualization, project administration, methodology, writing, review.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned, externally peer reviewed.

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