Introduction/Background Cytoreductive surgery (CRS) followed by hyperthermic intraperitoneal chemotherapy (HIPEC) with cisplatin is a widely used strategy in the treatment of ovarian carcinomatosis. Although it seems to improve the patients‘ survival, one of its most important adverse effects is postoperative acute kidney injury (AKI). The aim of our study was to assess the incidence and identify the predictive risk factors of AKI after CRS and cisplatin-based HIPEC.
Methodology This is a retrospective study from two centres evaluating patients with advanced or recurrent ovarian cancer who underwent CRS followed by cisplatin-based HIPEC from January 2007 to December 2013. Patients were classified in two groups according to the occurrence of AKI, defined when glomerular filtration rate at postoperative day-7 was 25% lower than at day-0. We also evaluated AKI 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 AKI occurrence.
Results Sixty-six patients were included: 29 (44%) underwent first-line treatment while 37 (56%) were treated for recurrent disease. The incidence of postoperative AKI was 48%. Table 1 displays the univariate analysis. After multivariate analysis, hypertension (OR 18.6; 95% CI 1.9–182.3; p=0.012) and low intraoperative diuresis (OR 0.5; 95% CI 0.4–0.8; p=0.001) were associated with AKI occurrence.
Conclusion The incidence of AKI after CRS and cisplatin-based HIPEC was high. Hypertension and low intraoperative diuresis were independent risk factors for this complication. An adequate perioperative hydration, in order to maintain a correct diuresis, could decrease acute kidney injury occurrence in patients undergoing CRS plus HIPEC. Table 2 shows general recommendations to decrease this complication.
Disclosure Nothing to disclose.
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